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Journal of Case Reports
Bisphosphonates Induced Atypical Femoral Fracture in Metastatic Breast Cancer: Misleading Benign Problem in a Malignant Condition
Islam Mubark, Mosab Elgalli, Keith Hayward
Department of Orthopaedics Surgery, Burton Queen’s Hospital, United Kingdom.
Corresponding Author:
Dr. Islam Mubark
Email: islam.mokhtar81@gmail.com
Received: 14-MAY-2017 Accepted: 05-SEP-2017 Published Online: 30-SEP-2017
DOI: http://dx.doi.org/10.17659/01.2017.0088
Abstract
Background: Diagnosing bisphosphonates induced atypical femoral fracture (AFF) in patient with bony metastasis can be challenging and overlooked. Case Report: We present a case of atypical sub-trochanteric femoral fracture in a patient treated successively with Zoledronic acid and Denosumab with known skeletal metastasis from breast carcinoma. The fracture was fixed using cephalo-medullary nail. Conclusion: Clinical oncologists should consider the possibility of AFFs in patients on long-term bisphosphonates treatment for bone metastases. Inability to identify those lesions as different from original malignant condition can lead to delayed diagnosis, sub-optimal treatment and missing opportunity to prevent progression of incomplete to complete fractures.
Keywords : Bone Neoplasms, Breast Neoplasms, Diphosphonates, Denosumab, Femoral Fractures.
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