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Establishment of diagnostic criteria for bowed atypical femur fracture and clarification of its clinical significance

Research Project

Project/Area Number 19K18451
Research Category

Grant-in-Aid for Early-Career Scientists

Allocation TypeMulti-year Fund
Review Section Basic Section 56020:Orthopedics-related
Research InstitutionTokyo Medical and Dental University

Principal Investigator

Oh Yoto  東京医科歯科大学, 大学院医歯学総合研究科, 寄附講座講師 (40754437)

Project Period (FY) 2019-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2021: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2020: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2019: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Keywords大腿骨骨折 / 非定型大腿骨骨折 / 生体力学解析 / 病理組織学的解析 / 多施設研究
Outline of Research at the Start

研究代表者はCT有限要素解析を用いた先行研究で、生体力学的な観点から、大腿骨弯曲変形による過剰ストレスで骨幹部中央に非定型大腿骨骨折が発症しうることを証明し報告すると同時に、骨幹部近位の転子下領域に発症する典型的な非定型大腿骨骨折と区別する新しい概念を報告した。
本研究では多施設共同研究で非定型大腿骨骨折患者を集積し、発症部位別に患者を分類し、生体力学解析と病理組織学的解析を行う。サブタイプ別に発症要因を同定することで弯曲型非定型大腿骨骨折の診断基準を確立され、病態に即した治療法の提供が可能となることから、臨床的意義の大きい研究と考える。

Outline of Final Research Achievements

In this multicenter study, we examined the characteristics of atypical femoral fractures according to the fracture location. We quantitatively evaluated the mechanical pathogenesis and bone strength by biomechanical analysis using CT-based finite element method, and analyzed the biological activity of the fracture healing process by histopathological analysis of the fracture site. As a result of this research, a new concept for classifying atypical femoral fractures into subtypes was reported for the first time in the world.

Academic Significance and Societal Importance of the Research Achievements

本研究では、非定型大腿骨骨折をサブタイプ別に分類する新しい概念を世界で初めて報告した。本研究を発展させ、非定型大腿骨骨折の基礎病態別に症例を分類し解析を行うことで、サブタイプ別に発症要因を同定し診断基準を確立することが期待される。さらにその臨床的意義を検証し、病態に即したた内科的・外科的治療法をサブタイプ別に提唱することが可能となることから、臨床的意義が非常に大きい研究と考える。

Report

(6 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • 2020 Research-status Report
  • 2019 Research-status Report
  • Research Products

    (22 results)

All 2023 2022 2021 2020 2019

All Journal Article (4 results) (of which Peer Reviewed: 2 results,  Open Access: 2 results) Presentation (18 results) (of which Int'l Joint Research: 5 results,  Invited: 12 results)

  • [Journal Article] 非定型大腿骨骨折のサブタイプ分類とその臨床応用2023

    • Author(s)
      王耀東、吉井俊貴、大川淳
    • Journal Title

      日本整形外科学会雑誌

      Volume: 97 Pages: 238-244

    • Related Report
      2023 Annual Research Report
  • [Journal Article] 非定型大腿骨骨折のサブタイプ分類と臨床応用2023

    • Author(s)
      王耀東
    • Journal Title

      Monthy Book Orthopaedics【非定型大腿骨骨折をひも解く】 大川淳・王耀東編,全日本病院出版会

      Volume: 36 Pages: 25-31

    • Related Report
      2023 Annual Research Report
  • [Journal Article] Current concept of stress fractures with an additional category of atypical fractures: a perspective review with representative images2021

    • Author(s)
      Oh Yoto、Yamamoto Kouhei、Yoshii Toshitaka、Kitagawa Masanobu、Okawa Atsushi
    • Journal Title

      Therapeutic Advances in Endocrinology and Metabolism

      Volume: 12 Pages: 1-8

    • DOI

      10.1177/20420188211049619

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Biological activity is not suppressed in mid-shaft stress fracture of the bowed femoral shaft unlike in “typical” atypical subtrochanteric femoral fracture: A proposed theory of atypical femoral fracture subtypes2020

    • Author(s)
      Oh Yoto、Yamamoto Kouhei、Hashimoto Jun、Fujita Koji、Yoshii Toshitaka、Fukushima Kazuyuki、Kurosa Yoshiro、Wakabayashi Yoshiaki、Kitagawa Masanobu、Okawa Atsushi
    • Journal Title

      Bone

      Volume: 137 Pages: 115453-115453

    • DOI

      10.1016/j.bone.2020.115453

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] 非定型大腿骨骨折診療のススメ-サブタイプ別の病態と治療-2023

    • Author(s)
      王耀東、吉井俊貴、大川淳
    • Organizer
      第96回日本整形外科学会学術総会
    • Related Report
      2023 Annual Research Report
    • Invited
  • [Presentation] がん患者の骨修飾薬投与と非定型大腿骨骨折-医原性骨折リスクを念頭においた集学的骨転移診療の勧め-2023

    • Author(s)
      王耀東、加来拓実、佐藤信吾、吉井俊貴
    • Organizer
      第49回日本骨折治療学会学術集会
    • Related Report
      2023 Annual Research Report
    • Invited
  • [Presentation] 非定型大腿骨骨折のサブタイプ分類とその臨床応用2022

    • Author(s)
      王耀東、吉井俊貴、大川淳
    • Organizer
      第95回日本整形外科学会学術総会
    • Related Report
      2022 Research-status Report
    • Invited
  • [Presentation] 非定型大腿骨骨折のサブタイプ分類(Oh理論)に基づいた外科的治療2022

    • Author(s)
      王耀東
    • Organizer
      第49回日本股関節学会学術集会
    • Related Report
      2022 Research-status Report
    • Invited
  • [Presentation] TKA術後に発症した非定型大腿骨インプラント周囲骨折の病態解明-病理組織学的分析とCT有限要素解析による検証-2021

    • Author(s)
      橋本淳、王耀東、吉井俊貴、大川淳
    • Organizer
      第94回日本整形外科学会学術総会
    • Related Report
      2021 Research-status Report
  • [Presentation] 非定型大腿骨骨折の診断と治療-東アジアと欧米の類似点・相違点-2021

    • Author(s)
      王耀東
    • Organizer
      第47回日本骨折治療学会学術集会
    • Related Report
      2021 Research-status Report
    • Invited
  • [Presentation] 非定型大腿骨骨折の手術治療-サブタイプ分類に基づいた留意点-2020

    • Author(s)
      王耀東
    • Organizer
      第60回関東整形災害外科学会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] 非定型大腿骨骨折に対するOh分類の検証2020

    • Author(s)
      王耀東、加来拓実、大川淳
    • Organizer
      第46回日本骨折治療学会
    • Related Report
      2020 Research-status Report
  • [Presentation] 非定型大腿骨骨折に対するCT有限要素解析2020

    • Author(s)
      王耀東、大川淳
    • Organizer
      第14回日本CAOS研究会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] 非定型大腿骨骨折の病態と治療-骨転移診療における留意点-2020

    • Author(s)
      王耀東
    • Organizer
      第7回東京骨転移フォーラム
    • Related Report
      2019 Research-status Report
    • Invited
  • [Presentation] Surgical treatment of atypical femoral fracture based on the subtype classification2019

    • Author(s)
      Oh Y
    • Organizer
      45th annual meeting of the Korean Fracture Society
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research / Invited
  • [Presentation] Validation of novel classification for atypical femoral fractures2019

    • Author(s)
      Oh Y
    • Organizer
      4th AOTrauma Asia Pacific Scientific Congress
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research / Invited
  • [Presentation] Biological activity in mid-shaft stress fracture of the bowed femoral shaft is not suppressed as in atypical subtrochanteric femoral fracture: validation of newly devised subtype classification for atypical femoral fracture2019

    • Author(s)
      Oh Y, Yamamoto K, Fujita K, Hashimoto J, Wakabayashi Y, Fukushima K, Kurosa Y, Kitagawa M, Okawa A
    • Organizer
      4th AOTrauma Asia Pacific Scientific Congress
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research
  • [Presentation] Atypical subtrochanteric femoral fracture associated with bowing deformity and total knee arthroplasty: a case report2019

    • Author(s)
      Hashimoto J, Oh Y, Yamamoto K, Kitagawa M, Okawa A
    • Organizer
      4th AOTrauma Asia Pacific Scientific Congress
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research
  • [Presentation] Validation of newly devised subtype classification for atypical femoral fracture2019

    • Author(s)
      Oh Y, Yamamoto K, Hashimoto J, Fujita K, Yoshii T, Fukushima K, Kurosa Y, Wakabayashi Y, Kitagawa M, Okawa A
    • Organizer
      8th FFN Global Congress
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research
  • [Presentation] 人工膝関節全置換術後に発症した大腿骨弯曲変形を伴う非定型大腿骨転子下骨折の1例-CT有限要素法力学解析と病理組織学的分析による病態解明-2019

    • Author(s)
      橋本淳、王耀東、吉井俊貴、大川淳
    • Organizer
      第68回東日本整形災害外科学会
    • Related Report
      2019 Research-status Report
  • [Presentation] Fetish for atypical femoral fracture: Recommendation for the use of Oh classification2019

    • Author(s)
      王耀東
    • Organizer
      6th TMED(Trauma Mania Exciting Dialog) 2019
    • Related Report
      2019 Research-status Report
    • Invited
  • [Presentation] 大腿骨形態と非定型大腿骨骨折-CT有限要素解析を基に-2019

    • Author(s)
      王耀東、藤田浩二、吉井俊貴、田野敦寛、福島和之、黒佐義郎、若林良明、大川淳
    • Organizer
      第46回日本臨床バイオメカニクス学会
    • Related Report
      2019 Research-status Report
    • Invited

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Published: 2019-04-18   Modified: 2025-01-30  

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