The ASBMR (American Society for Bone and Mineral Research) criteria for atypical femoral fractures is a diagnostic tool designed to identify patients who have experienced a specific type of femoral fracture that is often associated with long-term use of bisphosphonates. This tool is particularly useful in differentiating atypical femoral fractures from other types of femoral fractures, which can guide appropriate treatment strategies.
The primary components of the ASBMR criteria include five key characteristics of the fracture, each of which contributes one point to the total score. These characteristics include: the fracture being associated with minimal or no trauma, such as a fall from a standing height or less; the fracture line originating at the lateral cortex and being substantially transverse in its orientation; the fracture extending through both cortices and possibly being associated with a medial spike, or in the case of incomplete fractures, involving only the lateral cortex; the fracture being noncomminuted or minimally comminuted; and the presence of localized periosteal or endosteal thickening of the lateral cortex - known as "beaking" or "flaring" - at the fracture site.
The total score is determined by adding one point for each characteristic that is present, with a maximum possible score of five. A score of four or more indicates that the patient meets the diagnostic criteria for an atypical femoral fracture. If the score is less than four, the diagnostic criteria are not met, suggesting that the fracture is likely of a different type.
Reference
Giuseppe Toro, Cristina Ojeda-Thies, Giampiero Calabro et al. Management of atypical femoral fracture: a scoping review and comprehensive algorithm. BMC Musculoskelet Disord. 2016 May 23:17:227.
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