vmireavizВестник медицинского института «РЕАВИЗ». Реабилитация, Врач и ЗдоровьеBulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)2226-762X2782-1579РЕАВИЗ10.20340/vmi-rvz.2026.1.CLIN.11vmireaviz-1370Research ArticleКлиническая медицинаClinical medicineМетод двухопорной двухполюсной фиксации при переломе шейки бедренной костиBiplane Double Support Screw Fixation due to femoral neck fracturehttps://orcid.org/0009-0003-9512-9594НазаровД. С.NazarovD. S.

Назаров Диловар Саъдуллоевич, Врач травматолог-ортопед, аспирант кафедры травматологии и ортопедии

 ул. Миклухо-Маклая, д. 6, г. Москва, 117198, Россия 

Dilovar S. Nazarov, Traumatologist-orthopedist, postgraduate student in the Department of Traumatology and Orthopedics

Miklukho-Maklaya st., 6, Moscow, 117198, Russia

dilovarnazarov95@mail.ruhttps://orcid.org/0000-0002-6736-9772ЗагороднийН. В.ZagorodniyN. V.

Загородний Николай Васильевич, Д-р мед. наук, профессор, академик РАН, зав. кафедрой травматологии и  ортопедии

ул. Миклухо-Маклая, д. 6, г. Москва, 117198, Россия

Nikolay V. Zagorodniy, Dr. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Head of the Department of Traumatology and Orthopedics

Miklukho-Maklaya st., 6, Moscow, 117198, Russia

 

zagorodniy51@mail.ruhttps://orcid.org/0000-0001-7507-7772АйрапетовГ. А.AyrapetovG. A.

Айрапетов Георгий Александрович, Д-р мед. наук, профессор кафедры травматологии и ортопедии

ул. Миклухо-Маклая, д. 6, г. Москва, 117198, Россия

Georgiy A. Ayrapetov, Dr. Sci. (Med.), Professor, Department of Traumatology and Orthopedics

Miklukho-Maklaya st., 6, Moscow, 117198, Russia

 

airapetovga@yandex.ruhttps://orcid.org/0000-0002-2002-5091МироновА. Н.MironovA. N.

Миронов Андрей Николаевич, Врач травматолог-ортопед, заведующий отделением

ул. Лобачевского д. 42 стр. 1, г. Москва, 119415, Россия

Andrey N. Mironov, Traumatologist-orthopedist, Head of Department

Lobachevsky St., 42, building 1, Moscow, 119415, Russia

dr.mironov.andrey@gmail.comhttps://orcid.org/0009-0003-6129-0347ЛукинМ. П.LukinM. P.

Лукин Максим Прокопьевич, Канд. мед. наук, врач-травматолог-ортопед

ул. Лобачевского д. 42 стр. 1, г. Москва, 119415, Россия

Maksim P. Lukin, Cand. Sci. (Med.), Traumatologist-orthopedist

Lobachevsky St., 42, building 1, Moscow, 119415, Russia

mad_max1979@mail.ruhttps://orcid.org/0009-0001-8442-2061КарповичН. И.KarpovichN. I.

Карпович Николай Иванович, Канд. мед. наук, врач-травматолог-ортопед

ул. Лобачевского д. 42 стр. 1, г. Москва, 119415, Россия

Nikolay I. Karpovich, Cand. Sci. (Med.), traumatologist-orthopedist

Miklukho-Maklaya st., 6, Moscow, 117198, Russia

galen7@yandex.ruhttps://orcid.org/0000-0002-4671-0847БурковД. В.BurkovD. V.

Бурков Дмитрий Владимирович, Канд. мед. наук, врач травматолог-ортопед

ул. Лобачевского д. 42 стр. 1, г. Москва, 119415, Россия

Dmitriy V. Burkov, Cand. Sci. (Med.), traumatologist-orthopedist

Lobachevsky St., 42, building 1, Moscow, 119415, Russia 

arthrodv@mail.ruРоссийский университет дружбы народов имени Патриса ЛумумбыРоссияPatrice Lumumba Peoples' Friendship University of RussiaRussian FederationГородская клиническая больница № 31 имени академика Г.М. СавельевойРоссияCity Clinical Hospital No. 31 named after Academician G.M. SavelyevaRussian Federation202620052026161107114Copyright © Назаров Д.С., Загородний Н.В., Айрапетов Г.А., Миронов А.Н., Лукин М.П., Карпович Н.И., Бурков Д.В., 20262026Назаров Д.С., Загородний Н.В., Айрапетов Г.А., Миронов А.Н., Лукин М.П., Карпович Н.И., Бурков Д.В.Nazarov D.S., Zagorodniy N.V., Ayrapetov G.A., Mironov A.N., Lukin M.P., Karpovich N.I., Burkov D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestnik.reaviz.ru/jour/article/view/1370

Введение. Перелом шейки бедренной кости – один из самых распространённых переломов у пожилых людей. Количество переломов шейки бедренной кости растёт в связи с увеличением заболеваемости остеопорозом, ухудшением зрения у пожилых людей, нарушением нервно-мышечной координации, малоподвижным образом жизни, в целом с увеличением продолжительности жизни. Классические методы фиксации таких переломов часто приводят к плохим результатам и высокому уровню осложнений. Так, частота осложнений при остеосинтезе шейки бедра составляет до 46%. Метод двухопорной двухполюсной фиксации представляет собой новый подход, который предполагает одновременное размещение винтов в двух плоскостях, создавая двухточечную опору для винтов в шейке и головке бедренной кости. Цель исследования: оценка эффективности метода двухопорной двухполюсной фиксации при лечении пациентов с переломом шейки бедренной кости в возрасте 22–86 лет. Материалы и методы. В общей сложности 28 пациентам со свежими переломами шейки бедра (давностью менее двух недель) была проведена закрытая репозиция и внутренняя фиксация с использованием метода двухопорной фиксации. Функциональные результаты пациентов оценивались с использованием шкалы Харриса, а также были оценены рентгенологические результаты сращения, укорочения шейки бедра, латерализация винтов и аваскулярного некроза головки бедренной кости (АВН). Результаты. Результаты показали, что методика двухопорной двухполюсной фиксации является безопасным и эффективным методом остеосинтеза при переломе шейки бедренной кости как у молодых, так и у пожилых пациентов. Из 28 исследуемых, находившихся под наблюдением, 1 пациент отказался от дальнейшего наблюдения. В течение среднего периода наблюдения (20 месяцев, диапазон 6–24 месяца) в 21 (78%) случае переломы рентгенологически срастались в среднем за 6 месяцев. Несращение произошло у трёх пациентов (22%), а ещё у трёх пациентов (12%) наблюдалась миграция имплантов. У одного пациента произошёл периимплантный перелом (2,7%). У двух пациентов произошёл варусный коллапс, но их переломы успешно срослись (7,4%). Заключение. Техника двухопорной фиксации обладает рядом преимуществ по сравнению с традиционными методами, включая повышенную стабильность и прочность фиксации. Его можно рассматривать как альтернативу традиционным методам лечения переломов шейки бедренной кости с низкой частотой несращения, аваскулярного некроза и отсутствием случаев нарушения фиксации или варусного коллапса.

Background. Femoral neck fracture is one of the most common fractures in the elderly. The number of femoral neck fractures is increasing due to an increase in the incidence of osteoporosis, impaired vision in the elderly, impaired neuromuscular coordination, sedentary lifestyle, and an increase in life expectancy in general. Traditional methods of fixing such fractures often lead to poor results and a high level of complications. Thus, the incidence of complications in osteosynthesis of the femoral neck is up to 46%. The two-pole bipolar fixation method is a new approach that involves the simultaneous placement of screws in two planes, creating a two-point support for screws in the neck and head of the femur. Aim. The purpose of this study is to evaluate the effectiveness of the two-support bipolar fixation method in the treatment of patients with femoral neck fracture aged 22-86 years. Methods. A total of 28 patients with fresh hip fractures (less than two weeks old) underwent closed reposition and internal fixation using the method of two-support fixation. The functional results of the patients were evaluated using the Harris scale, and the radiological results of fusion, shortening of the femoral neck, lateralization of screws and avascular necrosis of the femoral head (AVN) were also evaluated. Results. The results showed that the technique of double-support bipolar fixation is a safe and effective osteosynthesis for fracture of the femoral neck in both young and elderly patients. Of the 28 subjects under observation, 1 patient refused further follow-up. On average, within 20 months (range 6-24 months), 21 (78%) fractures radiographically healed in an average of 6 months. Non-union occurred in three patients (22%), and three patients (12%) had implant migration. One patient had a peri-implant fracture (2.7%). Two patients had varus collapse, but their fractures successfully healed (7.4%). Conclusion. The two-support fixation technique has a number of advantages over traditional methods, including increased stability and strength of fixation. It can be considered as an alternative to traditional methods of treating femoral neck fractures with a low incidence of non-union, avascular necrosis and the absence of cases of fixation disorders or varus collapse.

перелом шейки бедренной кости [D005265]остеосинтез [D005592]двухопорная фиксация [D001899]закрытая репозиция [D005591]аваскулярный некроз головки бедра [D005271]несращение перелома [D005599]остеопороз [D010024]шкала Харриса [D006615]миграция импланта [D011475]варусная деформация [D006618]femoral neck fracture [D005265]internal fixation [D005592]bipolar fixation [D001899]closed reduction [D005591]avascular necrosis of femoral head [D005271]fracture nonunion [D005599]osteoporosis [D010024]Harris Hip Score [D006615]implant migration [D011475]varus collapse [D006618]ReferencesSami A, Prabhakar R, Kumar Yadav A, Kumar Jain V. Biplane double supported screw fixation for femoral neck fracture in young adults: A prospective cohort study. J Orthop. 2022 Jul 31;33:117-123. https://doi.org/10.1016/j.jor.2022.07.012Sami A, Prabhakar R, Kumar Yadav A, Kumar Jain V. Biplane double supported screw fixation for femoral neck fracture in young adults: A prospective cohort study. J Orthop. 2022 Jul 31;33:117-123. https://doi.org/10.1016/j.jor.2022.07.012Liddicoat M. National Hip Fracture Data Base (NHFD), 2017. https://www.researchgate.net/publication/329673879_National_Hip_Fracture_Data_Base_NHFD_2017_annual_reportLiddicoat M. National Hip Fracture Data Base (NHFD), 2017. https://www.researchgate.net/publication/329673879_National_Hip_Fracture_Data_Base_NHFD_2017_annual_reportCampenfeldt P, Al-Ani A, Ekström W, Zeraati B, Greve K, Cederholm T, Hedström M. Function, sarcopenia and osteoporosis 10 years after a femoral neck fracture in patients younger than 70 years. Injury. 2022 Apr;53(4):1496-1503. https://doi.org/10.1016/j.injury.2021.12.030. Epub 2021 Dec 22.Campenfeldt P, Al-Ani A, Ekström W, Zeraati B, Greve K, Cederholm T, Hedström M. Function, sarcopenia and osteoporosis 10 years after a femoral neck fracture in patients younger than 70 years. Injury. 2022 Apr;53(4):1496-1503. https://doi.org/10.1016/j.injury.2021.12.030. Epub 2021 Dec 22.Ramadanov N, Jóźwiak K, Hauptmann M, Lazaru P, Marinova-Kichikova P, Dimitrov D, Becker R. Cannulated screws versus dynamic hip screw versus hemiarthroplasty versus total hip arthroplasty in patients with displaced and non-displaced femoral neck fractures: a systematic review and frequentist network meta-analysis of 5703 patients. J Orthop Surg Res. 2023 Aug 26;18(1):625. https://doi.org/10.1186/s13018-023-04114-8Ramadanov N, Jóźwiak K, Hauptmann M, Lazaru P, Marinova-Kichikova P, Dimitrov D, Becker R. Cannulated screws versus dynamic hip screw versus hemiarthroplasty versus total hip arthroplasty in patients with displaced and non-displaced femoral neck fractures: a systematic review and frequentist network meta-analysis of 5703 patients. J Orthop Surg Res. 2023 Aug 26;18(1):625. https://doi.org/10.1186/s13018-023-04114-8Vluggen TPMJ, van Vugt R, Boonen B, Keulen MHF. Management of two-level proximal femoral fractures. BMJ Case Rep. 2021 May 31;14(5):e240684. https://doi.org/10.1136/bcr-2020-240684Vluggen TPMJ, van Vugt R, Boonen B, Keulen MHF. Management of two-level proximal femoral fractures. BMJ Case Rep. 2021 May 31;14(5):e240684. https://doi.org/10.1136/bcr-2020-240684Filipov OB. Biplane Double-supported Screw Fixation of Femoral Neck Fractures: Surgical Technique and Surgical Notes. J Am Acad Orthop Surg. 2019 Jun 1;27(11):e507-e515. https://doi.org/10.5435/JAAOS-D-17-00117Filipov OB. Biplane Double-supported Screw Fixation of Femoral Neck Fractures: Surgical Technique and Surgical Notes. J Am Acad Orthop Surg. 2019 Jun 1;27(11):e507-e515. https://doi.org/10.5435/JAAOS-D-17-00117Galal S, Nagy M. Non-parallel screw fixation for femoral neck fractures in young adults. J Clin Orthop Trauma. 2017 Jul-Sep;8(3):220-224. https://doi.org/10.1016/j.jcot.2017.07.003Galal S, Nagy M. Non-parallel screw fixation for femoral neck fractures in young adults. J Clin Orthop Trauma. 2017 Jul-Sep;8(3):220-224. https://doi.org/10.1016/j.jcot.2017.07.003Ren H, Zhang X, Liang Y, Yi C, Li D. Morphological analysis of posterior-medial intertrochanteric fracture patterns using fracture-mapping technique. Front Bioeng Biotechnol. 2023 Nov 9;11:1275204. https://doi.org/10.3389/fbioe.2023.1275204Ren H, Zhang X, Liang Y, Yi C, Li D. Morphological analysis of posterior-medial intertrochanteric fracture patterns using fracture-mapping technique. Front Bioeng Biotechnol. 2023 Nov 9;11:1275204. https://doi.org/10.3389/fbioe.2023.1275204Jaya Raj J, Kow RY, Ganthel Annamalai K, Kunasingh DE, Panicker GK, Lim BC, Low CL. Outcomes of Femoral Neck Fractures in Young Patients and the Factors Associated With Complications: A Multicenter Study From Malaysia. Cureus. 2021 Sep 19;13(9):e18110. https://doi.org/10.7759/cureus.18110Jaya Raj J, Kow RY, Ganthel Annamalai K, Kunasingh DE, Panicker GK, Lim BC, Low CL. Outcomes of Femoral Neck Fractures in Young Patients and the Factors Associated With Complications: A Multicenter Study From Malaysia. Cureus. 2021 Sep 19;13(9):e18110. https://doi.org/10.7759/cureus.18110Kim SJ, Park HS, Lee DW. Complications after internal screw fixation of nondisplaced femoral neck fractures in elderly patients: A systematic review. Acta Orthop Traumatol Turc. 2020 May;54(3):337-343. https://doi.org/10.5152/j.aott.2020.03.113Kim SJ, Park HS, Lee DW. Complications after internal screw fixation of nondisplaced femoral neck fractures in elderly patients: A systematic review. Acta Orthop Traumatol Turc. 2020 May;54(3):337-343. https://doi.org/10.5152/j.aott.2020.03.113Olansen J, Ibrahim Z, Aaron RK. Management of Garden-I and II Femoral Neck Fractures: Perspectives on Primary Arthroplasty. Orthop Res Rev. 2024 Jan 3;16:1-20. https://doi.org/10.2147/ORR.S340535Olansen J, Ibrahim Z, Aaron RK. Management of Garden-I and II Femoral Neck Fractures: Perspectives on Primary Arthroplasty. Orthop Res Rev. 2024 Jan 3;16:1-20. https://doi.org/10.2147/ORR.S340535Slobogean GP, Sprague SA, Scott T, Bhandari M. Complications following young femoral neck fractures. Injury. 2015 Mar;46(3):484-91. https://doi.org/10.1016/j.injury.2014.10.010Slobogean GP, Sprague SA, Scott T, Bhandari M. Complications following young femoral neck fractures. Injury. 2015 Mar;46(3):484-91. https://doi.org/10.1016/j.injury.2014.10.010Konarski W, Poboży T, Kotela A, Śliwczyński A, Kotela I, Hordowicz M, Krakowiak J. The Risk of Avascular Necrosis Following the Stabilization of Femoral Neck Fractures: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022 Aug 15;19(16):10050. https://doi.org/10.3390/ijerph191610050Konarski W, Poboży T, Kotela A, Śliwczyński A, Kotela I, Hordowicz M, Krakowiak J. The Risk of Avascular Necrosis Following the Stabilization of Femoral Neck Fractures: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022 Aug 15;19(16):10050. https://doi.org/10.3390/ijerph191610050Yoon JY, Lee SJ, Yoon KS, Yoon PW. The diagnostic value of SPECT/CT in predicting the occurrence of osteonecrosis following femoral neck fracture: a prospective cohort study. BMC Musculoskelet Disord. 2020 Aug 3;21(1):517. https://doi.org/10.1186/s12891-020-03538-1Yoon JY, Lee SJ, Yoon KS, Yoon PW. The diagnostic value of SPECT/CT in predicting the occurrence of osteonecrosis following femoral neck fracture: a prospective cohort study. BMC Musculoskelet Disord. 2020 Aug 3;21(1):517. https://doi.org/10.1186/s12891-020-03538-1Wu C. et al. Efficacy and complications after delayed fixation of femoral neck fractures in children. Journal of Orthopaedic Surgery. 2019;28(1). https://doi.org/10.1177/2309499019889682Wu C. et al. Efficacy and complications after delayed fixation of femoral neck fractures in children. Journal of Orthopaedic Surgery. 2019;28(1). https://doi.org/10.1177/2309499019889682Mukka S., Sjöholm P., Aziz A. et al. A cohort study comparing internal fixation for undisplaced versus hip arthroplasty for displaced femoral neck fracture in the elderly: a pilot study for a clinical trial. Pilot Feasibility Stud. 2020;6:98. https://doi.org/10.1186/s40814-020-00642-wMukka S., Sjöholm P., Aziz A. et al. A cohort study comparing internal fixation for undisplaced versus hip arthroplasty for displaced femoral neck fracture in the elderly: a pilot study for a clinical trial. Pilot Feasibility Stud. 2020;6:98. https://doi.org/10.1186/s40814-020-00642-wPei F., Zhao R., Li F. et al. Osteonecrosis of femoral head in young patients with femoral neck fracture: a retrospective study of 250 patients followed for average of 7.5 years. J Orthop Surg Res. 2020;15:238. https://doi.org/10.1186/s13018-020-01724-4Pei F., Zhao R., Li F. et al. Osteonecrosis of femoral head in young patients with femoral neck fracture: a retrospective study of 250 patients followed for average of 7.5 years. J Orthop Surg Res. 2020;15:238. https://doi.org/10.1186/s13018-020-01724-4Huang K., Fang X., Li G. et al. Assessing the effect of Gotfried reduction with positive buttress pattern in the young femoral neck fracture. J Orthop Surg Res. 2020;15:511. https://doi.org/10.1186/s13018-020-02039-0Huang K., Fang X., Li G. et al. Assessing the effect of Gotfried reduction with positive buttress pattern in the young femoral neck fracture. J Orthop Surg Res. 2020;15:511. https://doi.org/10.1186/s13018-020-02039-0Kim CH., Shin M., Lee D. et al. Hidden osteonecrosis of the femoral head after healed femoral neck fractures: magnetic resonance imaging study of 58 consecutive patients. Arch Orthop Trauma Surg. 2022;142:1443–1450. https://doi.org/10.1007/s00402-021-03802-6Kim CH., Shin M., Lee D. et al. Hidden osteonecrosis of the femoral head after healed femoral neck fractures: magnetic resonance imaging study of 58 consecutive patients. Arch Orthop Trauma Surg. 2022;142:1443–1450. https://doi.org/10.1007/s00402-021-03802-6Wang SH, Yang JJ, Shen HC, Lin LC, Lee MS and Pan RY. Using a modified Pauwels method to predict the outcome of femoral neck fracture in relatively young patients. Injury. 2015;46:1969-74.Wang SH, Yang JJ, Shen HC, Lin LC, Lee MS and Pan RY. Using a modified Pauwels method to predict the outcome of femoral neck fracture in relatively young patients. Injury. 2015;46:1969-74.Su Z, Liang L, Hao Y. Medial femoral plate with cannulated screw for Pauwels type III femoral neck fracture: A meta-analysis. J Back Musculoskelet Rehabil. 2021;34(2):169-177. https://doi.org/10.3233/BMR-200183Su Z, Liang L, Hao Y. Medial femoral plate with cannulated screw for Pauwels type III femoral neck fracture: A meta-analysis. J Back Musculoskelet Rehabil. 2021;34(2):169-177. https://doi.org/10.3233/BMR-200183Huang H, Feng Z, Wang W, Yang C, Liao J, Ouyang J. Finite Element Analysis of Femoral Neck Fracture Treated with Bidirectional Compression-Limited Sliding Screw. Med Sci Monit. 2021 Mar 30;27:e929163. https://doi.org/10.12659/MSM.929163Huang H, Feng Z, Wang W, Yang C, Liao J, Ouyang J. Finite Element Analysis of Femoral Neck Fracture Treated with Bidirectional Compression-Limited Sliding Screw. Med Sci Monit. 2021 Mar 30;27:e929163. https://doi.org/10.12659/MSM.929163Li N, Cheng KY, Fan J, Li Y, Yang M, Zhu S, Jiang X. Evaluating three internal fixation techniques for Pauwels III femoral neck fractures via finite element analysis. Sci Rep. 2024 Jul 5;14(1):15519. https://doi.org/10.1038/s41598-024-66638-1Li N, Cheng KY, Fan J, Li Y, Yang M, Zhu S, Jiang X. Evaluating three internal fixation techniques for Pauwels III femoral neck fractures via finite element analysis. Sci Rep. 2024 Jul 5;14(1):15519. https://doi.org/10.1038/s41598-024-66638-1Ding M, Su Z, Wang D, Mo L, Mei J, Sun W, Li S, Ni M. Biomechanical comparison of Gofried positive support reduction of Pauwels type III femoral neck fractures: A finite elements analysis. Injury. 2024 Dec;55(12):111979. https://doi.org/10.1016/j.injury.2024.111979Ding M, Su Z, Wang D, Mo L, Mei J, Sun W, Li S, Ni M. Biomechanical comparison of Gofried positive support reduction of Pauwels type III femoral neck fractures: A finite elements analysis. Injury. 2024 Dec;55(12):111979. https://doi.org/10.1016/j.injury.2024.111979Cha YH, Yoo JI, Hwang SY, Kim KJ, Kim HY, Choy WS, Hwang SC. Biomechanical Evaluation of Internal Fixation of Pauwels Type III Femoral Neck Fractures: A Systematic Review of Various Fixation Methods. Clin Orthop Surg. 2019 Mar;11(1):1-14. https://doi.org/10.4055/cios.2019.11.1.1Cha YH, Yoo JI, Hwang SY, Kim KJ, Kim HY, Choy WS, Hwang SC. Biomechanical Evaluation of Internal Fixation of Pauwels Type III Femoral Neck Fractures: A Systematic Review of Various Fixation Methods. Clin Orthop Surg. 2019 Mar;11(1):1-14. https://doi.org/10.4055/cios.2019.11.1.1Kim JW, Oh CW, Park KH, Oh JK, Yoon YC, Kim JK. Peri-implant atypical femoral fracture after nail or plate osteosynthesis. J Orthop Sci. 2022 Jul;27(4):866-875. https://doi.org/10.1016/j.jos.2021.04.008Kim JW, Oh CW, Park KH, Oh JK, Yoon YC, Kim JK. Peri-implant atypical femoral fracture after nail or plate osteosynthesis. J Orthop Sci. 2022 Jul;27(4):866-875. https://doi.org/10.1016/j.jos.2021.04.008Makkar B, Obremskey W, Avidano R, Ott S, Basida B, Hoffer C, Schousboe JT, Lo J, Huling J, Ristau K, Fink HA, Adler RA, Barzilay JI, Carbone L. The definition of atypical femoral fractures should include periprosthetic femoral fractures (PAFFs). Osteoporos Int. 2025 Mar;36(3):539-546. https://doi.org/10.1007/s00198-025-07401-8Makkar B, Obremskey W, Avidano R, Ott S, Basida B, Hoffer C, Schousboe JT, Lo J, Huling J, Ristau K, Fink HA, Adler RA, Barzilay JI, Carbone L. The definition of atypical femoral fractures should include periprosthetic femoral fractures (PAFFs). Osteoporos Int. 2025 Mar;36(3):539-546. https://doi.org/10.1007/s00198-025-07401-8Hashimoto J, Oh Y, Yamamoto K, Yoshii T, Fukushima K, Kitagawa M, Okawa A. Frequency and pathogenesis of periprosthetic atypical femoral fractures associated with total knee arthroplasty: A multicenter prospective study with complementary histopathological and biomechanical analysis. Injury. 2024 Jun;55(6):111136. https://doi.org/10.1016/j.injury.2023.111136Hashimoto J, Oh Y, Yamamoto K, Yoshii T, Fukushima K, Kitagawa M, Okawa A. Frequency and pathogenesis of periprosthetic atypical femoral fractures associated with total knee arthroplasty: A multicenter prospective study with complementary histopathological and biomechanical analysis. Injury. 2024 Jun;55(6):111136. https://doi.org/10.1016/j.injury.2023.111136Jeong SY, Hwang KT, Oh CW, Kim JW, Sohn OJ, Kim JW, Cho YH, Park KC. Mid-term outcomes after the surgical treatment of atypical femoral fractures: minimum three-year follow-up. Bone Joint J. 2021 Nov;103-B(11):1648-1655. https://doi.org/10.1302/0301-620X.103B11Jeong SY, Hwang KT, Oh CW, Kim JW, Sohn OJ, Kim JW, Cho YH, Park KC. Mid-term outcomes after the surgical treatment of atypical femoral fractures: minimum three-year follow-up. Bone Joint J. 2021 Nov;103-B(11):1648-1655. https://doi.org/10.1302/0301-620X.103B11Woo SB, Choi ST, Chan WL. Atypical periprosthetic femoral fracture: a case report. J Orthop Surg (Hong Kong). 2016 Aug;24(2):269-72. https://doi.org/10.1177/1602400230Woo SB, Choi ST, Chan WL. Atypical periprosthetic femoral fracture: a case report. J Orthop Surg (Hong Kong). 2016 Aug;24(2):269-72. https://doi.org/10.1177/1602400230

The authors declare that there are no conflicts of interest present.