\u00bfExiste asociaci\u00f3n entre el trazo y las complicaciones intra y posquir\u00fargicas?<\/strong><\/p>[\/et_pb_text][et_pb_blurb title=\u00bbMart\u00edn Turco (1), Gonzalo Ranzuglia (2), Carlos L. J. Turra (2), Martin Boubila (2)\u00bb use_icon=\u00bbon\u00bb font_icon=\u00bb||divi||400″ icon_color=\u00bb#3cbebe\u00bb icon_placement=\u00bbleft\u00bb content_max_width=\u00bb1100px\u00bb image_icon_width_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.14.9″ header_font=\u00bb|600|||||||\u00bb header_font_size=\u00bb18px\u00bb header_line_height=\u00bb1.6em\u00bb body_font=\u00bb||||||||\u00bb body_font_size=\u00bb15px\u00bb body_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ header_font_size_tablet=\u00bb\u00bb header_font_size_phone=\u00bb15px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb body_line_height_tablet=\u00bb\u00bb body_line_height_phone=\u00bb1.6em\u00bb body_line_height_last_edited=\u00bbon|phone\u00bb image_max_width_phone=\u00bb50px\u00bb image_max_width_last_edited=\u00bboff|desktop\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″] (1) M\u00e9dico Especialista en Ortopedia y Traumatolog\u00eda y en Medicina del Deporte. Citaci\u00f3n sugerida:<\/strong> Turco M, Ranzuglia G, Turra CLJ y Boubila M. Fracturas at\u00edpicas de f\u00e9mur por bifosfonatos. Anuario (Fund. Dr. J. R. Villavicencio) Introducci\u00f3n: La osteoporosis afecta al sistema \u00f3seo predisponiendo a fracturas como principal complicaci\u00f3n. Bifosfonatos, fracturas at\u00edpicas, femur, pseudoartrosis.<\/p>[\/et_pb_text][et_pb_text _builder_version=\u00bb4.14.9″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″] Bisphosphonates, atypical femur fractures, pseudoarthrosis<\/p>[\/et_pb_text][et_pb_text _builder_version=\u00bb4.14.9″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″] La Osteoporosis se define como una enfermedad que afecta al sistema musculoesquel\u00e9tico y se caracteriza por la disminuci\u00f3n de la masa mineral \u00f3sea con deterioro en la microarquitectura del tejido \u00f3seo, que predispone a sufrir fracturas como principal complicaci\u00f3n.1 El objetivo de esta presentaci\u00f3n es mostrar las diferencias encontradas dentro del espectro de estas fracturas at\u00edpicas de f\u00e9mur, con respecto a la ubicaci\u00f3n del tipo de trazo de la misma, para considerarlas distintas al momento de su resoluci\u00f3n quir\u00fargica por su posible asociaci\u00f3n a complicaciones intra y postquir\u00fargicas.<\/p>[\/et_pb_text][et_pb_text _builder_version=\u00bb4.14.9″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″] Las fracturas con trazo diafisarias no presentaron complicaciones intraquir\u00fargicas ni postquir\u00fargicas. El tiempo de consolidaci\u00f3n promedio fue de 6 meses. En concordancia con la literatura m\u00e9dica cient\u00edfica. Los bifosfonatos contin\u00faan siendo el pilar en el trata tratamiento para prevenir las complicaciones de la osteoporosis. En nuestra serie de 14 casos de fracturas at\u00edpicas, 5 de todos los ellas (fractura con trazo de ubicaci\u00f3n diafisaria), consolidaron satisfactoriamente y se encuentran reincorporados a actividades habituales de la vida diaria, sin inconvenientes a largo plazo de seguimiento.<\/p>\n Por el contrario en los casos en que la fractura fue de ubicaci\u00f3n subtrocant\u00e9rica (9 casos) se produjeron complicaciones, Los autores declaran no tener conflicto de intereses.<\/p>[\/et_pb_text][et_pb_text _builder_version=\u00bb4.4.6″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb][\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=\u00bb3.25″ locked=\u00bboff\u00bb collapsed=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_column type=\u00bb4_4″ _builder_version=\u00bb3.25″ custom_padding=\u00bb|||\u00bb global_colors_info=\u00bb{}\u00bb custom_padding__hover=\u00bb|||\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_text _builder_version=\u00bb4.4.6″ text_font=\u00bbEB Garamond|700|||||||\u00bb text_text_color=\u00bbrgba(0,0,0,0.02)\u00bb text_font_size=\u00bb80px\u00bb text_line_height=\u00bb0em\u00bb header_2_font=\u00bbEB Garamond||||||||\u00bb header_2_font_size=\u00bb50px\u00bb header_2_line_height=\u00bb1.3em\u00bb text_orientation=\u00bbcenter\u00bb text_font_size_tablet=\u00bb50px\u00bb text_font_size_phone=\u00bb30px\u00bb text_font_size_last_edited=\u00bbon|desktop\u00bb header_2_font_size_tablet=\u00bb40px\u00bb header_2_font_size_phone=\u00bb30px\u00bb header_2_font_size_last_edited=\u00bbon|phone\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb] FIGURAS<\/p>\n Enclavado medular en trazo fracturario diafisario<\/p>[\/et_pb_blurb][et_pb_image src=\u00bbhttps:\/\/villavicencio.org.ar\/anuario\/wp-content\/uploads\/2022\/03\/Fracturas-atipicas-1.jpg\u00bb title_text=\u00bbFracturas-atipicas-1″ align=\u00bbcenter\u00bb _builder_version=\u00bb4.14.9″ hover_enabled=\u00bb0″ border_radii=\u00bbon|39px|39px|39px|39px\u00bb border_width_all=\u00bb5px\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″][\/et_pb_image][et_pb_blurb title=\u00bbFigura 2 – Consolidaci\u00f3n de trazo fracturario diafisario\u00bb use_icon=\u00bbon\u00bb font_icon=\u00bbZ||divi||400″ icon_color=\u00bb#3cbebe\u00bb icon_placement=\u00bbleft\u00bb content_max_width=\u00bb1100px\u00bb image_icon_width_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.14.9″ header_font=\u00bb|600|||||||\u00bb header_font_size=\u00bb18px\u00bb header_line_height=\u00bb1.6em\u00bb body_font=\u00bb||||||||\u00bb body_font_size=\u00bb15px\u00bb body_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ header_font_size_tablet=\u00bb\u00bb header_font_size_phone=\u00bb15px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb body_line_height_tablet=\u00bb\u00bb body_line_height_phone=\u00bb1.6em\u00bb body_line_height_last_edited=\u00bbon|phone\u00bb image_max_width_phone=\u00bb50px\u00bb image_max_width_last_edited=\u00bboff|desktop\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″] Consolidaci\u00f3n de trazo fracturario diafisario<\/p>[\/et_pb_blurb][et_pb_image src=\u00bbhttps:\/\/villavicencio.org.ar\/anuario\/wp-content\/uploads\/2022\/03\/Fracturas-atipicas-2.jpg\u00bb title_text=\u00bbFracturas-atipicas-2″ align=\u00bbcenter\u00bb _builder_version=\u00bb4.14.9″ hover_enabled=\u00bb0″ border_radii=\u00bbon|39px|39px|39px|39px\u00bb border_width_all=\u00bb5px\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″][\/et_pb_image][et_pb_blurb title=\u00bbFigura 3 – Trazo fracturario subtrocant\u00e9rico\u00bb use_icon=\u00bbon\u00bb font_icon=\u00bbZ||divi||400″ icon_color=\u00bb#3cbebe\u00bb icon_placement=\u00bbleft\u00bb content_max_width=\u00bb1100px\u00bb image_icon_width_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.14.9″ header_font=\u00bb|600|||||||\u00bb header_font_size=\u00bb18px\u00bb header_line_height=\u00bb1.6em\u00bb body_font=\u00bb||||||||\u00bb body_font_size=\u00bb15px\u00bb body_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ header_font_size_tablet=\u00bb\u00bb header_font_size_phone=\u00bb15px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb body_line_height_tablet=\u00bb\u00bb body_line_height_phone=\u00bb1.6em\u00bb body_line_height_last_edited=\u00bbon|phone\u00bb image_max_width_phone=\u00bb50px\u00bb image_max_width_last_edited=\u00bboff|desktop\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″] Trazo fracturario subtrocant\u00e9rico.<\/p>[\/et_pb_blurb][et_pb_image src=\u00bbhttps:\/\/villavicencio.org.ar\/anuario\/wp-content\/uploads\/2022\/03\/Fracturas-atipicas-3.jpg\u00bb title_text=\u00bbFracturas-atipicas-3″ align=\u00bbcenter\u00bb _builder_version=\u00bb4.14.9″ hover_enabled=\u00bb0″ border_radii=\u00bbon|39px|39px|39px|39px\u00bb border_width_all=\u00bb5px\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″][\/et_pb_image][et_pb_blurb title=\u00bbFigura 4 – Resoluci\u00f3n de fractura subtrocant\u00e9rica\u00bb use_icon=\u00bbon\u00bb font_icon=\u00bbZ||divi||400″ icon_color=\u00bb#3cbebe\u00bb icon_placement=\u00bbleft\u00bb content_max_width=\u00bb1100px\u00bb image_icon_width_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.14.9″ header_font=\u00bb|600|||||||\u00bb header_font_size=\u00bb18px\u00bb header_line_height=\u00bb1.6em\u00bb body_font=\u00bb||||||||\u00bb body_font_size=\u00bb15px\u00bb body_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ header_font_size_tablet=\u00bb\u00bb header_font_size_phone=\u00bb15px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb body_line_height_tablet=\u00bb\u00bb body_line_height_phone=\u00bb1.6em\u00bb body_line_height_last_edited=\u00bbon|phone\u00bb image_max_width_phone=\u00bb50px\u00bb image_max_width_last_edited=\u00bboff|desktop\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″] Resoluci\u00f3n de fractura subtrocant\u00e9rica mediante osteos\u00edntesis con clavo placa con tornillo din\u00e1mico de cadera DHS.<\/p>[\/et_pb_blurb][et_pb_image src=\u00bbhttps:\/\/villavicencio.org.ar\/anuario\/wp-content\/uploads\/2022\/03\/Fracturas-atipicas-4.jpg\u00bb title_text=\u00bbFracturas-atipicas-4″ align=\u00bbcenter\u00bb _builder_version=\u00bb4.14.9″ hover_enabled=\u00bb0″ border_radii=\u00bbon|39px|39px|39px|39px\u00bb border_width_all=\u00bb5px\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″][\/et_pb_image][et_pb_blurb title=\u00bbFigura 5 -Resoluci\u00f3n definitiva de fractura subtrocant\u00e9rica\u00bb use_icon=\u00bbon\u00bb font_icon=\u00bbZ||divi||400″ icon_color=\u00bb#3cbebe\u00bb icon_placement=\u00bbleft\u00bb content_max_width=\u00bb1100px\u00bb image_icon_width_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.14.9″ header_font=\u00bb|600|||||||\u00bb header_font_size=\u00bb18px\u00bb header_line_height=\u00bb1.6em\u00bb body_font=\u00bb||||||||\u00bb body_font_size=\u00bb15px\u00bb body_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ header_font_size_tablet=\u00bb\u00bb header_font_size_phone=\u00bb15px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb body_line_height_tablet=\u00bb\u00bb body_line_height_phone=\u00bb1.6em\u00bb body_line_height_last_edited=\u00bbon|phone\u00bb image_max_width_phone=\u00bb50px\u00bb image_max_width_last_edited=\u00bboff|desktop\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″] Luego de m\u00faltiples intervenciones se realiz\u00f3 una artroplast\u00eda total de cadera no convencional.<\/p>[\/et_pb_blurb][et_pb_image src=\u00bbhttps:\/\/villavicencio.org.ar\/anuario\/wp-content\/uploads\/2022\/03\/Fracturas-atipicas-5.jpg\u00bb title_text=\u00bbFracturas-atipicas-5″ align=\u00bbcenter\u00bb _builder_version=\u00bb4.14.9″ hover_enabled=\u00bb0″ border_radii=\u00bbon|39px|39px|39px|39px\u00bb border_width_all=\u00bb5px\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″][\/et_pb_image][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00bb1″ admin_label=\u00bbCourses\u00bb _builder_version=\u00bb3.22″ custom_padding=\u00bb1px|0px|62px|0px|false|false\u00bb collapsed=\u00bbon\u00bb global_colors_info=\u00bb{}\u00bb locked=\u00bboff\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_row custom_padding_last_edited=\u00bbon|phone\u00bb _builder_version=\u00bb3.25″ background_color=\u00bb#ffffff\u00bb max_width=\u00bb1280px\u00bb custom_padding=\u00bb12px|40px|12px|40px|true|false\u00bb 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header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″] 1. Molina-Restrepo JF, Gonz\u00e1lez-Naranjo LA. Osteoporosis: enfoque cl\u00ednico y de laboratorio. Medicina y Laboratorio. 2010;16:111-140. La osteoporosis afecta al sistema \u00f3seo predisponiendo a fracturas como principal complicaci\u00f3n.
(2) M\u00e9dico Especialista en Ortopedia y Traumatolog\u00eda.
Sanatorio Parque – Bv. Oro\u00f1o 860, (2000) Rosario, Argentina
Correspondencia<\/strong> a: martinturco@live.com.ar<\/p>[\/et_pb_blurb][et_pb_text _builder_version=\u00bb4.14.9″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb13px\u00bb text_line_height=\u00bb1.6em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]
2022;29. Disponible en: http:\/\/www.villavicencio.org.ar\/PORTAL\/index.php?sis=2&ubq=4&scc=11&men=35<\/p>[\/et_pb_text][et_pb_button button_url=\u00bb\/anuario\/wp-content\/uploads\/2022\/03\/Turco-Fracturas-atipicas.pdf\u00bb url_new_window=\u00bbon\u00bb button_text=\u00bbDescargar art\u00edculo\u00bb button_alignment=\u00bbright\u00bb _builder_version=\u00bb4.14.9″ custom_button=\u00bbon\u00bb button_text_size=\u00bb12px\u00bb button_text_color=\u00bb#3cbebe\u00bb button_bg_color=\u00bbrgba(60,190,190,0.1)\u00bb button_border_width=\u00bb10px\u00bb button_border_color=\u00bbrgba(0,0,0,0)\u00bb button_border_radius=\u00bb100px\u00bb button_letter_spacing=\u00bb1px\u00bb button_font=\u00bb|700||on|||||\u00bb custom_padding=\u00bb10px|20px|10px|20px|true|true\u00bb hover_enabled=\u00bb0″ button_letter_spacing_hover=\u00bb1px\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb button_text_size__hover_enabled=\u00bboff\u00bb button_one_text_size__hover_enabled=\u00bboff\u00bb button_two_text_size__hover_enabled=\u00bboff\u00bb button_text_color__hover_enabled=\u00bboff\u00bb button_one_text_color__hover_enabled=\u00bboff\u00bb button_two_text_color__hover_enabled=\u00bboff\u00bb button_border_width__hover_enabled=\u00bboff\u00bb button_one_border_width__hover_enabled=\u00bboff\u00bb button_two_border_width__hover_enabled=\u00bboff\u00bb button_border_color__hover_enabled=\u00bboff\u00bb button_one_border_color__hover_enabled=\u00bboff\u00bb button_two_border_color__hover_enabled=\u00bboff\u00bb button_border_radius__hover_enabled=\u00bboff\u00bb button_one_border_radius__hover_enabled=\u00bboff\u00bb button_two_border_radius__hover_enabled=\u00bboff\u00bb button_letter_spacing__hover_enabled=\u00bbon\u00bb button_letter_spacing__hover=\u00bb1px\u00bb button_one_letter_spacing__hover_enabled=\u00bboff\u00bb button_two_letter_spacing__hover_enabled=\u00bboff\u00bb button_bg_color__hover_enabled=\u00bboff\u00bb button_one_bg_color__hover_enabled=\u00bboff\u00bb button_two_bg_color__hover_enabled=\u00bboff\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″][\/et_pb_button][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00bb1″ admin_label=\u00bbCourses\u00bb _builder_version=\u00bb3.22″ custom_padding=\u00bb1px|0px|62px|0px|false|false\u00bb collapsed=\u00bbon\u00bb global_colors_info=\u00bb{}\u00bb locked=\u00bboff\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_row custom_padding_last_edited=\u00bbon|phone\u00bb _builder_version=\u00bb3.25″ background_color=\u00bb#ffffff\u00bb max_width=\u00bb1280px\u00bb custom_padding=\u00bb12px|40px|12px|40px|true|false\u00bb custom_padding_tablet=\u00bb\u00bb custom_padding_phone=\u00bb|20px||20px||true\u00bb animation_style=\u00bbzoom\u00bb animation_intensity_zoom=\u00bb2%\u00bb border_radii=\u00bbon|12px|12px|12px|12px\u00bb box_shadow_style=\u00bbpreset1″ box_shadow_vertical=\u00bb50px\u00bb box_shadow_blur=\u00bb80px\u00bb box_shadow_color=\u00bbrgba(15,19,25,0.1)\u00bb use_custom_width=\u00bbon\u00bb custom_width_px=\u00bb1280px\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_column type=\u00bb4_4″ _builder_version=\u00bb3.25″ custom_padding=\u00bb|||\u00bb global_colors_info=\u00bb{}\u00bb custom_padding__hover=\u00bb|||\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_text _builder_version=\u00bb4.14.9″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]Resumen<\/h3>\n
La terapia con bifosfonatos es de elecci\u00f3n para prevenirlas. La administraci\u00f3n por periodos prolongados predispone a sufrir fracturas de f\u00e9mur denominadas at\u00edpicas.
El objetivo es analizar las diferencias encontradas dentro del espectro de estas fracturas, con respecto al tipo de trazo, para considerarlas distintas al momento de su resoluci\u00f3n quir\u00fargica por su posible asociaci\u00f3n a complicaciones intra y postquir\u00fargicas.
Material y m\u00e9todos: An\u00e1lisis retrospectivo de fracturas at\u00edpicas de f\u00e9mur en nuestro servicio tratadas quir\u00fargicamente entre 2012 y 2014. Se revisaron historias cl\u00ednicas, protocolos quir\u00fargicos, y radiograf\u00edas posoperatorias de seguimiento durante 5 a\u00f1os.
Se contabilizaron catorce (14) fracturas at\u00edpicas de f\u00e9mur, todas del sexo femenino, que hab\u00edan consumido bifosfonatos por m\u00e1s de 5 a\u00f1os.
De ellas, cinco (5) fueron diafisarias y nueve (9) subtrocant\u00e9ricas.
Se registraron las complicaciones intraquir\u00fargicas y postquir\u00fargicas (fracturas agregadas, retardo consolidaci\u00f3n y Pseudoartrosis) y la necesidad de procedimiento quir\u00fargicos extra.
Resultados: Las fracturas con trazo diafisarias no presentaron complicaciones. El tiempo de consolidaci\u00f3n promedio fue de 6 meses. En concordancia con la literatura m\u00e9dica cient\u00edfica.
Las de ubicaci\u00f3n subtrocant\u00e9ricas: En dos (2) de ellas se presentaron complicaciones intraquir\u00fargicas ortop\u00e9dicas, retardo de consolidaci\u00f3n y Pseudoartrosis.
Tuvieron que ser reintervenidas quir\u00fargicamente.
Conclusi\u00f3n: Si bien la etiopatogenia, y el tipo de trazo son similares, las diferencias entre las de ubicaci\u00f3n diafisaria y subtrocant\u00e9ricas podr\u00edan marcar un pron\u00f3stico con respecto a la prevalencia de complicaciones intra y postquir\u00fargicas.<\/p>[\/et_pb_text][et_pb_text _builder_version=\u00bb4.14.9″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]Palabras clave<\/h3>\n
Atypical femur fractures due to bisphosphonates Is there an association between stroke and intra- and post-surgical complications?<\/h1>[\/et_pb_text][et_pb_text _builder_version=\u00bb4.14.9″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]
Abstract<\/h3>\nIntroduction: Osteoporosis affects the bone system being fractures the main complication. Bisphosphonate therapy is the treatment of choice to prevent them; however its administration for prolonged periods predisposes to suffer the so called atypical fractures.\nObjective: To analyse the differences found within the spectrum of these fractures, with respect to the type of stroke, in order to consider them different at the time of the surgical resolution due to their possible association with intraoperative and postoperative complications Material and Methods: Retrospective analysis of atypical femoral fractures surgically treated in our service between 2012 and 2014. Medical records,surgical protocols, and postoperative follow-up xrays were reviewed for 5 years.\nFourteen (14) atypical femur fractures of women who had consumed bisphosphonates for more than 5 years were observed. Of these, five (5) were diaphyseal and nine (9) subtrochanteric. Intraoperative and postoperative complications (aggregate fractures, delayed consolidation and pseudarthrosis) and the need for extra surgical procedures were recorded.\nResults: The diaphyseal traced fractures did not present complications. The average healing time was 6 months, in agreement with the scientific medical literature. Subtrochanteric fractures: two (2) of them presented intraoperative orthopedic complications, delayed healing and pseudarthrosis and had to be surgically reoperated.\nConclusion: Although the etiopathogenesis and type of stroke are similar, the differences between those of diaphyseal and ubtrochanteric location could determine a prognosis with respect to the prevalence of intraoperative and postoperative complications.[\/et_pb_text][et_pb_text _builder_version=\u00bb4.14.9″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]
Keywords<\/h3>\n
Introducci\u00f3n<\/h3>\n
El tratamiento con bifosfonatos es uno de los pilares terap\u00e9uticospara disminuir y\/o contrarrestar tal patolog\u00eda, con seguridad probada, sin embargo est\u00e1 ampliamente descripto en la bibliograf\u00eda cient\u00edfica que su uso prolongado, puede generar cambios en la arquitectura \u00f3sea, haci\u00e9ndolo m\u00e1s r\u00edgido, con riesgo de provocar fracturas en f\u00e9mur denominadas At\u00edpicas.2,3
Estas se generan sin trauma de gran magnitud, y presentan caracter\u00edsticas radiol\u00f3gicas similares, con trazo transversal u oblicuo corto, esp\u00edcula medial y aumento de la cortical externa, a nivel subtrocant\u00e9ricas y\/o diafisario.
Estas requieren tratamiento quir\u00fargico con una gama de dispositivos endomedulares con cerrojos cef\u00e1lico, proximal y\/o distal seg\u00fan el caso.4,5<\/p>[\/et_pb_text][et_pb_text _builder_version=\u00bb4.14.9″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]Objetivos<\/h3>\n
Material o poblaci\u00f3n y m\u00e9todos<\/h3>\nSe analiz\u00f3 de forma retrospectiva las fracturas at\u00edpicas de f\u00e9mur en nuestro servicio tratadas quir\u00fargicamente en el periodo entre el a\u00f1o 2012 y 2014. Se revisaron historias cl\u00ednicas, protocolos quir\u00fargicos, y radiograf\u00edas posoperatorias de seguimiento (5 a\u00f1os).\nSe contabilizaron 14 fracturas de f\u00e9mur en 12 pacientes (2 bilaterales, no simult\u00e1neas).\nTodas en el sexo femenino, con una edad promedio 70 a\u00f1os (rango 59-82 a\u00f1os).\nLas mismas se produjeron como consecuencia de trauma indirecto m\u00ednimo (muy baja energ\u00eda), sin ca\u00eddas, que hab\u00edan recibido tratamiento con bifosfonatos por m\u00e1s de 5 a\u00f1os.\nDel total, 7 fueron del lado derecho, 7 del lado izquierdo.\nEn cuanto al trazo de fractura, 5 presentaron trazo simple diafisario. En 9 subtrocant\u00e9ricas.\nSe contabilizaron y registraron cuales fueron las complicaciones intraquir\u00fargicas y postquir\u00fargicas (fracturas o trazos fracturarios agregados, retardo consolidaci\u00f3n y Pseudoartrosis) y la necesidad de procedimientos quir\u00fargicos agregados posteriormente.[\/et_pb_text][et_pb_text _builder_version=\u00bb4.14.9″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]
Resultados<\/h3>\n
Las de ubicaci\u00f3n subtrocant\u00e9ricas: dos de ellas presentaron complicaciones intraquir\u00fargicas, con trazos de fracturas agregadas asociadas al ingreso del iniciador.
Las mismas tuvieron que tratarse adem\u00e1s con otros sistemas en un primer tiempo (placas de osteos\u00edntesis y lazadas de alambre). Tuvieron que ser reintervenidas en varias ocasiones terminando en reemplazo articular (pr\u00f3tesis no convencional).
La Pseudoartrosis se gener\u00f3 en 5 de ellas. Todas fueron reoperadas con clavo cefalomedular (en dos de ellas se utiliz\u00f3 injerto aut\u00f3logo y de banco). El tiempo promedio de consolidaci\u00f3n de este segundo procedimiento fue de 12 meses promedio.
Por \u00faltimo las dos restantes tuvieron retardo con consolidaci\u00f3n de 11 meses (Figuras 1, 2, 3, 4 y 5).<\/p>[\/et_pb_text][et_pb_text _builder_version=\u00bb4.14.9″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]Discusi\u00f3n<\/h3>\n
Sin embargo en ocasiones por prescripci\u00f3n por largos periodos y sin control de los efectos de los mismos pueden ocasionar fracturas denominadas at\u00edpicas de f\u00e9mur. Probablemente por microtraumas asociados a cambios en la estructura \u00f3sea. Las mismas tienen un patr\u00f3n caracter\u00edstico en las radiograf\u00edas.
Tener en cuenta que el uso de bifosfonatos, demanda un control peri\u00f3dico para disminuir la incidencia de estas fracturas, las cuales solo suelen presentar m\u00ednimos pr\u00f3dromos de alerta.6
El tratamiento empleado para resolver esta patolog\u00eda continua siendo un dispositivo endomedular acerrojado largo ya que todo el hueso se halla afectado (enfermo), con cerrojos proximales, distales y\/o cef\u00e1licos seg\u00fan el caso requiera.
Si bien las fracturas At\u00edpicas de f\u00e9mur presentan en com\u00fan los antecedentes del consumo de bifosfonatos por largos periodos, los pr\u00f3dromos, el mecanismo de producci\u00f3n con m\u00ednima energ\u00eda, el trazo simple y las caracter\u00edsticas radiol\u00f3gicas del mismo7, genera interrogantes con respecto a la localizaci\u00f3n diafisario o subtrocant\u00e9rico ya que la tasa de complicaciones intra y postquir\u00fargicas (fracturas intraquir\u00fargicas, retardo de consolidaci\u00f3n y Pseudoartrosis) parecen tener relaci\u00f3n con las fracturas subtrocant\u00e9ricas en mayor medida que las que presentan ubicaci\u00f3n diafisaria.<\/p>[\/et_pb_text][et_pb_text _builder_version=\u00bb4.14.9″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]Conclusiones<\/h3>\n
intraoperatorias como el estallido del f\u00e9mur generando una fractura m\u00e1s extensa, retardo de consolidaci\u00f3n y Pseudoartrosis.
Estas complicaciones generaron la necesidad de reintervenciones quir\u00fargicos extras, incluso en dos casos que luego de m\u00faltiples operaciones finalizaron con pr\u00f3tesis no convencional de cadera).
Dado lo expuesto se podr\u00eda considerar que la localizaci\u00f3n de estas fracturas podr\u00eda tener repercusi\u00f3n sobre las complicaciones intra y postquir\u00fargicas.
La debilidad de esta presentaci\u00f3n radica en el n\u00famero (N) bajo de pacientes presentados en esta serie (aunque tambi\u00e9n sabemos que no hay reporte de muchos m\u00e1s casos en la literatura m\u00e9dica).6<\/p>[\/et_pb_text][et_pb_text _builder_version=\u00bb4.14.7″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb]Conflicto de intereses<\/h3>\n
Figuras<\/h2>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=\u00bb3.25″ locked=\u00bboff\u00bb collapsed=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_column type=\u00bb4_4″ _builder_version=\u00bb3.25″ custom_padding=\u00bb|||\u00bb global_colors_info=\u00bb{}\u00bb custom_padding__hover=\u00bb|||\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_blurb title=\u00bbFigura 1 – Trazo fracturario diafisario\u00bb use_icon=\u00bbon\u00bb font_icon=\u00bbZ||divi||400″ icon_color=\u00bb#3cbebe\u00bb icon_placement=\u00bbleft\u00bb content_max_width=\u00bb1100px\u00bb image_icon_width_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.14.9″ header_font=\u00bb|600|||||||\u00bb header_font_size=\u00bb18px\u00bb header_line_height=\u00bb1.6em\u00bb body_font=\u00bb||||||||\u00bb body_font_size=\u00bb15px\u00bb body_line_height=\u00bb2em\u00bb hover_enabled=\u00bb0″ header_font_size_tablet=\u00bb\u00bb header_font_size_phone=\u00bb15px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb body_line_height_tablet=\u00bb\u00bb body_line_height_phone=\u00bb1.6em\u00bb body_line_height_last_edited=\u00bbon|phone\u00bb image_max_width_phone=\u00bb50px\u00bb image_max_width_last_edited=\u00bboff|desktop\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]
Bibliograf\u00eda<\/h3>\n
2. Neviaser AS, Lane JM, Edobor-Osula F, Lorich DG.Low-energy femoral shaft fractures associated with alendronate use. J Orthop Trauma. 2008;22:346-350.
3. Restrepo RC, Vargas Grajales F, Felipe D\u00edaz OJ, Vel\u00e1squez Franco CJ, Zapata-Castellanos AL, Valencia JA. Fractura patol\u00f3gica atribuible a la terapia con bifosfonatos. Asociaci\u00f3n Colombiana de Reumatolog\u00eda. 2012;8:92-98.
4. Olivetto R, Olivetto AL, Olivetto JM. Fracturas femorales at\u00edpicas por bifosfonatos. Revista Cirug\u00eda Reconstructiva de Cadera y Rodilla. 2015;1:48-55.
5. Koh A, Guerado E, Giannoudis PV. Atypical femoral fractures related to bisphosphonate treatment. Bone Joint J. 2017;99:295-302.
6. Lim SJ, Yeo I, Yoon PW, Yoo JJ, Rhyu KH, Han SB, et al. Incidence, risk factors, and fracture healing of atypical femoral fractures: a multicenter case-control study. Osteoporos Int. 2018;29:2427-2435.
7. Haworth AE, Webb J. Skeletal complications of bisphosphonate use: what the radiologist should know. Br J Radiol. 2012;85:1333-1342.<\/p>[\/et_pb_text][et_pb_text _builder_version=\u00bb4.4.6″ text_font=\u00bb||||||||\u00bb text_font_size=\u00bb15px\u00bb text_line_height=\u00bb2em\u00bb header_font=\u00bb||||||||\u00bb header_2_font=\u00bb||||||||\u00bb header_3_font=\u00bbEB Garamond||||||||\u00bb header_3_font_size=\u00bb24px\u00bb header_3_line_height=\u00bb1.4em\u00bb header_4_font=\u00bb|700||on|||||\u00bb header_4_text_color=\u00bb#ffdaa4″ header_4_font_size=\u00bb12px\u00bb header_4_letter_spacing=\u00bb2px\u00bb header_4_line_height=\u00bb2em\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb1.6em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb][\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]\n\n","protected":false},"excerpt":{"rendered":"
\nLa terapia con bifosfonatos es de elecci\u00f3n para prevenirlas. La administraci\u00f3n por periodos prolongados predispone a sufrir fracturas de f\u00e9mur denominadas at\u00edpicas.
\nEl objetivo es analizar las diferencias encontradas dentro del espectro de estas fracturas<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[15,3],"tags":[18],"class_list":["post-718","post","type-post","status-publish","format-standard","hentry","category-15","category-articulos-originales-29","tag-anuario-29-2022"],"_links":{"self":[{"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/posts\/718","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/comments?post=718"}],"version-history":[{"count":9,"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/posts\/718\/revisions"}],"predecessor-version":[{"id":951,"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/posts\/718\/revisions\/951"}],"wp:attachment":[{"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/media?parent=718"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/categories?post=718"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/villavicencio.org.ar\/anuario\/wp-json\/wp\/v2\/tags?post=718"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}