非典型股骨骨折（AFFs）是一种骨质疏松症长期应用抗骨吸收治疗引起的严重并发症。规范诊疗骨质疏松症患者的AFFs，必须搞清AFFs的高危因素、诊断标准和相关治疗策略。
本文将对以上相关问题进行列表总结，以期为临床提供清晰、可操作的诊疗方案。
1. 骨质疏松症患者AFF的高危因素[1-3]
表1：
2.骨质疏松症患者AFF的诊断标准[4-5]
表2：
诊断路径关键提示：对于长期使用抗骨吸收药物（尤其是双膦酸盐或地舒单抗）的患者，若出现大腿、腹股沟或膝部慢性疼痛，应高度警惕AFF。首选双侧股骨全长X光片进行筛查；当X线结果不明确时，MRI是检测不完全骨折或早期骨膜反应最敏感的工具。
3.骨质疏松症患者不完全性AFF的治疗策略[6-7]
表3：
治疗原则总览：决策需高度个体化，综合权衡症状、功能影响、影像学风险特征及患者全身状况。双侧股骨影像检查必不可少（对侧受累率达28-40%）。同时，必须停用相关的抗骨吸收药物，并进行代谢评估与营养优化。
4.骨质疏松症患者完全性AFF的治疗策略[8-9]
表4：
治疗总原则：对于完全性AFF，髓内钉固定是金标准手术方法。成功治疗的关键在于：基于个体解剖（尤其弯曲度）选择最合适的内植物和技术，并同步启动全身性的骨骼健康管理。
参考文献
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