title: [Clinical heterogeneity of atypical fractures during prolonged use of bisphosphonates--risk factors and bone turnover markers].
abstract: We describe four cases of atypical femoral fractures treated at the Department of Endocrinology, Hospital de Clínicas, Federal University of Paraná (SEMPR) which, although characteristic of this type of fracture, presented clinical peculiarities that should be considered and serve as a warning in these patients, such as: late diagnosis with maintenance of bisphosphonates; absence of co-morbidities with excellent result; failure of fracture healing; use of anabolic medication after the fracture and the use of bone turnover markers at the follow up.
authors.affiliation: Departamento de Clínica Médica do Hospital de Clínicas, UFPR, Curitiba, PR, Brasil.
authors.forename: Giovana
authors.initials: G
authors.lastname: Piazzetta
authors.affiliation: Departamento de Ortopedia e Traumatologia do Hospital de Clínicas, UFPR, Curitiba, PR, Brasil.
authors.forename: Filipe R
authors.initials: FR
authors.lastname: Baracho
authors.affiliation: Departamento de Clínica Médica do Hospital de Clínicas, UFPR, Curitiba, PR, Brasil.
authors.forename: Larissa de
authors.initials: Ld
authors.lastname: Oliveira
authors.affiliation: Departamento de Clínica Médica do Hospital de Clínicas, UFPR, Curitiba, PR, Brasil.
authors.forename: Gustavo R
authors.initials: GR
authors.lastname: Santos
authors.affiliation: Departamento de Clínica Médica do Hospital de Clínicas, UFPR, Curitiba, PR, Brasil.
authors.forename: Carolina A M
authors.initials: CA
authors.lastname: Kulak
authors.affiliation: Departamento de Clínica Médica do Hospital de Clínicas, UFPR, Curitiba, PR, Brasil.
authors.forename: Victória Z C
authors.initials: VZ
authors.lastname: Borba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D015519:Bone Density; D016723:Bone Remodeling / Q000502:physiology; D024042:Collagen Type I / Q000378:metabolism; D057210:Delayed Diagnosis; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005264:Femoral Fractures / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000601:surgery; D005594:Fracture Fixation, Intramedullary / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D008875:Middle Aged; D015675:Osteocalcin / Q000378:metabolism*; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy; D010455:Peptides / Q000378:metabolism; D011859:Radiography; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D004164:Diphosphonates; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D015675:Osteocalcin