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Atypical Fracture of Proximal Ulna Associated with Prolonged Bisphosphonate Therapy Managed with Nonoperative Treatment: A
Case Report: and Literature Review

Konlawat Sabsuantang MD¹ , ², Nachapan Pengrung MD², Norachart Sirisreetreerux MD², Noratep Kulachote MD², Paphon Sa-ngasoongsong MD, MCh²

Affiliation : ¹ Chakri Naruebodindra Medical Institute, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ² Department of Orthopedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Prolonged bisphosphonate (BP) treatment is associated with some complications, such as atypical femoral fractures (AFFs). Recent studies showed that atypical fractures also occurred in other bones, especially in the atypical fracture of the proximal ulna (AFPU). Although, AFPUs frequently share the same characteristics of atypical fractures as AFFs, such as fracture configuration and high risk of non-union, there is still limited evidence of the role of non-operative treatment in AFPU. The aim of the present study was to present an interesting case involving an 80-year-old female presented with non-displaced AFPU after receiving long-term BP medication and had been treated with a conservative method for 2.5 years, and to review the literature regarding the available AFPU treatment options. To the best of the authors’ knowledge, the present case report introduced new insight of the outcome of non-operative treatment for AFPU.
Received 22 February 2021 | Revised 30 July 2021 | Accepted 5 August 2021

doi.org/10.35755/jmedassocthai.2021.09.12593

Keywords : Non-displaced fracture; Ulna fracture; Long-term bisphosphonates; Conservative treatment; Nonunion; Osteoporosis


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