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Case Reports   |    
A Lesson from the Failure of Intramedullary Fixation of Atypical Subtrochanteric FracturesA Report of Two Cases
Qiang Luo, MD1; Christian Fang, MBBS, FRCS, FHKCOS1; Wan-Yiu Shen, MBBS, FRCS, FHKCOS2; Tak-Wing Lau, MBBS, FRCS, FHKCOS1; Frankie Leung, MBBS, FRCS, FHKCOS1
1 Department of Orthopaedics and Traumatology, Queen Mary Hospital and The University of Hong Kong, 5/f, professorial block, Queen Mary Hospital, Pokfulam, Hong Kong, China. E-mail address for Q. Luo: lqhku@hku.hk. E-mail address for C. Fang: fangcx@gmail.com. E-mail address for T.-W. Lau: catcherlau@yahoo.com.hk. E-mail address for F. Leung: klleunga@hku.hk
2 Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China. E-mail address: wyshen@netvigator.com.
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Investigation performed at the Department of Orthopaedics and Traumatology, Queen Mary Hospital and The University of Hong Kong, Pokfulam, Hong Kong, China and the Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Mar 13;3(1):e22 1-4. doi: 10.2106/JBJS.CC.L.00212
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Extract

Surgical fixation of subtrochanteric fractures remains technically challenging, even to experienced fracture surgeons. These fractures are often treated with intramedullary devices; fixed-angle plating is an alternative. Recently, there have been an increasing number of reports about bisphosphonate-related atypical femoral fractures occurring at the subtrochanteric or proximal diaphyseal region1-4. These fractures are characterized by cortical beaking, thickening of the femoral cortex prior to fractures, and transverse or short oblique orientation in people who have been on long-term bisphosphonate therapy2,3,5,6.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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