title: Bisphosphonate use and increased incidence of subtrochanteric fracture in South Korea: results from the National Claim Registry.
abstract: CONCLUSIONS
  We evaluated trends in the incidences of typical and atypical hip fracture in relation to bisphosphonate use in Korea from 2006 to 2010, using nationwide data obtained from the Health Insurance Review and Assessment Service (HIRA).
  
  
  BACKGROUND
  Recently, atypical hip fractures in the subtrochanteric region have been reported among patients on bisphosphonate. However, the association between atypical hip fracture and bisphosphonate is controversial. We evaluated trends in the incidences of typical and atypical hip fracture in relation to bisphosphonate use in Korea from 2006 to 2010, using nationwide data obtained from the HIRA.
  
  
  METHODS
  All new visits or admissions to clinics or hospitals for a typical and atypical hip fractures were recorded nationwide by HIRA using the ICD-10 code classification. Typical and atypical hip fractures were defined as femoral neck/intertrochanteric and subtrochanteric fracture, respectively. Bisphosphonate prescription data were also abstracted from the HIRA database.
  
  
  RESULTS
  The absolute number of typical and atypical hip fracture increased during the study period. Although age-adjusted incidence rates of typical hip fractures were stable in men and women, those of atypical hip fractures increased in women. Nationally, the annual numbers of prescriptions of bisphosphonate also increased during the study period.
  
  
  CONCLUSIONS
  The results of this study suggest a possible causal relationship between bisphosphonate use and the increased incidence of atypical hip fracture in Korea.
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, 463-707, South Korea.
authors.forename: Y-K
authors.initials: YK
authors.lastname: Lee
authors.forename: Y-C
authors.initials: YC
authors.lastname: Ha
authors.forename: C
authors.initials: C
authors.lastname: Park
authors.forename: J J
authors.initials: JJ
authors.lastname: Yoo
authors.forename: C S
authors.initials: CS
authors.lastname: Shin
authors.forename: K-H
authors.initials: KH
authors.lastname: Koo
mesh_terms: D000368:Aged; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D016208:Databases, Factual; D004164:Diphosphonates / Q000009:adverse effects*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D006620:Hip Fractures / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates