Atypische Femurfrakturen – zwei Denkanstöße anhand von drei Fallstudien

 

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Zusammenfassung

Atypische Femurfrakturen machen 0,6–1,2 % aller Femurfrakturen aus (4, 5). Die American Society of Bone and Mineral Research (ASBMR) hat 2010 Major- und Minor-Kriterien vorgeschlagen (2) und diese 2014 präzisiert (3), anhand derer Femurfrakturen identifiziert werden. Wir möchten diskutieren, ob bei strikter Anwendung der ASBMR-Kriterien alle atypischen Femurfrakturen erkannt werden und stellen zwei Fälle vor, die suggestiv für das Vorliegen einer atypischen Femurfraktur sind, aber trotzdem nicht als solche gewertet werden. Mit einem weiteren Fall stellen wir das Basler M&M-Konzept zur Behandlung atypischer Femurfrakturen vor, womit biomechanisch-chirurgische (1. M = Mechanik) und medikamentöse (2. M = Medikamente) Behandlungskompetenz zusammengeführt werden.

Summary

Nowadays about 0,6–1,2 % of all femoral fractures are looked upon atypical (4, 5). In 2010 the American Society of Bone and Mineral Research (ASBMR) defined major and minor criteria to identify atypical femur fractures (AFF) (2, 3). In our experience we may not identify all cases of AFF when diagnostic criteria are rigidly applied. We demonstrate two cases of femoral fractures which are suspicious for an atypical femur fracture but do not meet all diagnostic criteria. Additionally we introduce the Basler M&M-Concept for the treatment of atypical femur fractures, which comprises the combination of biomechanical (surgery) and medical treatment competencies.

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