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Case Report: Prophylactic Plate Fixation for Incomplete Atypical Ulnar Fractures Resulting From the Use of Denosumab for Bone Metastases

Patients with bone metastases are treated with long-term bone resorption inhibitors such as bisphosphonates and denosumab. However, resorption inhibitors have been known to cause fractures, such as atypical femoral fractures (AFFs). In recent years, there have been an increasing number of reports of...

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Autores principales: Murai, Atsuro, Tada, Kaoru, Nakajima, Tadahiro, Akahane, Mika, Matsuta, Masashi, Nakamura, Yuta, Tsuchiya, Hiroyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8782234/
https://www.ncbi.nlm.nih.gov/pubmed/35069445
http://dx.doi.org/10.3389/fendo.2021.798653
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author Murai, Atsuro
Tada, Kaoru
Nakajima, Tadahiro
Akahane, Mika
Matsuta, Masashi
Nakamura, Yuta
Tsuchiya, Hiroyuki
author_facet Murai, Atsuro
Tada, Kaoru
Nakajima, Tadahiro
Akahane, Mika
Matsuta, Masashi
Nakamura, Yuta
Tsuchiya, Hiroyuki
author_sort Murai, Atsuro
collection PubMed
description Patients with bone metastases are treated with long-term bone resorption inhibitors such as bisphosphonates and denosumab. However, resorption inhibitors have been known to cause fractures, such as atypical femoral fractures (AFFs). In recent years, there have been an increasing number of reports of atypical ulna fractures (AUFs) caused by bone resorption inhibitor usage. Treatment of AUFs is complicated, especially when they occur in patients with bone metastases, because it is difficult to discontinue bone resorption inhibitor treatment without the risk of aggravating metastatic lesions. Prophylactic surgery is recommended in AFFs when fractures are predicted, but there are few reports of prophylactic surgery for AUFs. Here, we report a case of incomplete AUF in a 74-year-old woman which was surgically treated with prophylactic plate fixation. The patient had been using denosumab for 6 years to treat bone metastases due to thyroid cancer. After surgery, no fractures were observed for 2 years without discontinuing denosumab, and her forearm function was adequate. AUFs are rare and difficult to treat, so oncologists who treat bone metastases need to pay special attention to diagnose this incomplete AUF before the fracture worsens. We believe that detection of a possible fracture and prophylactic surgery can improve prognosis.
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spelling pubmed-87822342022-01-22 Case Report: Prophylactic Plate Fixation for Incomplete Atypical Ulnar Fractures Resulting From the Use of Denosumab for Bone Metastases Murai, Atsuro Tada, Kaoru Nakajima, Tadahiro Akahane, Mika Matsuta, Masashi Nakamura, Yuta Tsuchiya, Hiroyuki Front Endocrinol (Lausanne) Endocrinology Patients with bone metastases are treated with long-term bone resorption inhibitors such as bisphosphonates and denosumab. However, resorption inhibitors have been known to cause fractures, such as atypical femoral fractures (AFFs). In recent years, there have been an increasing number of reports of atypical ulna fractures (AUFs) caused by bone resorption inhibitor usage. Treatment of AUFs is complicated, especially when they occur in patients with bone metastases, because it is difficult to discontinue bone resorption inhibitor treatment without the risk of aggravating metastatic lesions. Prophylactic surgery is recommended in AFFs when fractures are predicted, but there are few reports of prophylactic surgery for AUFs. Here, we report a case of incomplete AUF in a 74-year-old woman which was surgically treated with prophylactic plate fixation. The patient had been using denosumab for 6 years to treat bone metastases due to thyroid cancer. After surgery, no fractures were observed for 2 years without discontinuing denosumab, and her forearm function was adequate. AUFs are rare and difficult to treat, so oncologists who treat bone metastases need to pay special attention to diagnose this incomplete AUF before the fracture worsens. We believe that detection of a possible fracture and prophylactic surgery can improve prognosis. Frontiers Media S.A. 2022-01-07 /pmc/articles/PMC8782234/ /pubmed/35069445 http://dx.doi.org/10.3389/fendo.2021.798653 Text en Copyright © 2022 Murai, Tada, Nakajima, Akahane, Matsuta, Nakamura and Tsuchiya https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Murai, Atsuro
Tada, Kaoru
Nakajima, Tadahiro
Akahane, Mika
Matsuta, Masashi
Nakamura, Yuta
Tsuchiya, Hiroyuki
Case Report: Prophylactic Plate Fixation for Incomplete Atypical Ulnar Fractures Resulting From the Use of Denosumab for Bone Metastases
title Case Report: Prophylactic Plate Fixation for Incomplete Atypical Ulnar Fractures Resulting From the Use of Denosumab for Bone Metastases
title_full Case Report: Prophylactic Plate Fixation for Incomplete Atypical Ulnar Fractures Resulting From the Use of Denosumab for Bone Metastases
title_fullStr Case Report: Prophylactic Plate Fixation for Incomplete Atypical Ulnar Fractures Resulting From the Use of Denosumab for Bone Metastases
title_full_unstemmed Case Report: Prophylactic Plate Fixation for Incomplete Atypical Ulnar Fractures Resulting From the Use of Denosumab for Bone Metastases
title_short Case Report: Prophylactic Plate Fixation for Incomplete Atypical Ulnar Fractures Resulting From the Use of Denosumab for Bone Metastases
title_sort case report: prophylactic plate fixation for incomplete atypical ulnar fractures resulting from the use of denosumab for bone metastases
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8782234/
https://www.ncbi.nlm.nih.gov/pubmed/35069445
http://dx.doi.org/10.3389/fendo.2021.798653
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