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The Role of Lower-Limb Geometry in the Pathophysiology of Atypical Femoral Fracture

  • Epidemiology and Pathophysiology (F Cosman and D Shoback, Section Editors)
  • Published:
Current Osteoporosis Reports Aims and scope Submit manuscript

Abstract

Purposeof Review

The etiology of atypical femoral fracture (AFF) is likely multifactorial. In this review, we examined the recent literature investigating the role of lower-limb geometry in the pathophysiology of AFF.

Recent Findings

Increased femoral bowing was associated with prevalent AFF and a greater likelihood of a diaphyseal versus a subtrochanteric AFF location. Femoral neck geometry or hip alignment may also be related to AFF, but findings remain equivocal. Differences in femoral geometry may, in part, be responsible for the high rate of AFF in Asian compared with Caucasian populations. Finally, simulation studies suggest that lower-limb geometry influences AFF risk via its effects on mechanical strain of the lateral femoral cortex.

Summary

Femoral geometry, and bowing in particular, is related to prevalent AFF, but more prospective investigation is needed to determine whether measurements of geometry can be used for clinical risk stratification.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, KNB 418, 2500 University Dr. NW, Calgary, Alberta, T2N 1N4, Canada

    Ifaz T. Haider & W. Brent Edwards

  2. McCaig Institute for Bone and Joint Health, University of Calgary, HRIC 3A08, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada

    Ifaz T. Haider, Prism S. Schneider & W. Brent Edwards

  3. Department of Surgery; Department of Community Health Sciences, Cumming School of Medicine, Foothills Campus, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada

    Prism S. Schneider

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Correspondence to W. Brent Edwards.

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Ifaz Haider and Brent Edwards reports grants from Amgen outside the submitted work. Prism Schneider declares no conflict of interest.

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Haider, I.T., Schneider, P.S. & Edwards, W.B. The Role of Lower-Limb Geometry in the Pathophysiology of Atypical Femoral Fracture. Curr Osteoporos Rep 17, 281–290 (2019). https://doi.org/10.1007/s11914-019-00525-x

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