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Incidence and medical management of bisphosphonate-associated atypical femoral fractures in a major trauma centre: a retrospective observational study

Overview of attention for article published in BMC Musculoskeletal Disorders, January 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (71st percentile)
  • Good Attention Score compared to outputs of the same age and source (75th percentile)

Mentioned by

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6 tweeters

Citations

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9 Dimensions

Readers on

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34 Mendeley
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1 CiteULike
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Title
Incidence and medical management of bisphosphonate-associated atypical femoral fractures in a major trauma centre: a retrospective observational study
Published in
BMC Musculoskeletal Disorders, January 2017
DOI 10.1186/s12891-017-1392-9
Pubmed ID
Authors

Neil Eisenstein, Ganesh Kasavkar, Dhruva Bhavsar, Faisal Shehzaad Khan, Zoe Paskins

Abstract

Atypical femoral fractures (AFFs) are rare events associated with increased duration of bisphosphonate exposure. Recommended management of AFFs include cessation of bisphosphonates and imaging of the contralateral femur. The aims of this study were to identify the local incidence of AFFs in bisphosphonate users and to audit the medical management of AFFs against published recommendations. A retrospective analysis of the admissions database for a major trauma centre identified all femoral fractures (3150) in a five-year period (July 2009 to June 2014). Electronic health records and radiographs were reviewed using the 2013 American Society for Bone and Mineral Research (ASBMR) diagnostic criteria for AFF to establish the number of cases. To estimate incidence, the total number of bisphosphonate users was derived from primary care prescription and secondary care day-case records. Medical management of cases with AFF on bisphosphonates was audited against guidance from ASBMR and Medicines & Healthcare Products Regulatory Agency. 10 out of 3150 femoral fractures met criteria for AFF; 7 of these patients had a history of exposure to bisphosphonates (6 oral, 1 intravenous). There were 19.1 AFFs per 100,000 years of bisphosphonate use in our region. Bisphosphonates were stopped and the contralateral femur imaged in only 2 of the 7 patients treated with bisphosphonates. Our local incidence is in line with published figures; however, this is the first published evidence suggesting that medical management and identification of AFF may be suboptimal. Managing these patients remains challenging due to their rarity and possible lack of awareness.

Twitter Demographics

The data shown below were collected from the profiles of 6 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 34 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 6 18%
Researcher 5 15%
Student > Master 4 12%
Student > Ph. D. Student 3 9%
Professor > Associate Professor 2 6%
Other 6 18%
Unknown 8 24%
Readers by discipline Count As %
Medicine and Dentistry 15 44%
Nursing and Health Professions 3 9%
Biochemistry, Genetics and Molecular Biology 2 6%
Computer Science 1 3%
Social Sciences 1 3%
Other 1 3%
Unknown 11 32%

Attention Score in Context

This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 February 2017.
All research outputs
#1,918,777
of 8,993,272 outputs
Outputs from BMC Musculoskeletal Disorders
#545
of 2,218 outputs
Outputs of similar age
#86,656
of 309,495 outputs
Outputs of similar age from BMC Musculoskeletal Disorders
#12
of 48 outputs
Altmetric has tracked 8,993,272 research outputs across all sources so far. Compared to these this one has done well and is in the 78th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,218 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.4. This one has done well, scoring higher than 75% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 309,495 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 71% of its contemporaries.
We're also able to compare this research output to 48 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 75% of its contemporaries.