Abstract
Long-term bisphosphonate use may be associated with atypical femoral fractures. In this report, we describe three cases of bisphosphonate-associated incomplete atypical femoral fracture, treated by prophylactic intramedullary nail fixation. Patients with long-term intake of bisphosphonates must be carefully monitored; atypical femoral fracture should be suspected in the presence of symptoms such as thigh pain. Its early identification is important to avoid a complete fracture and invasive surgery, and prophylactic fixation is recommended for incomplete atypical femoral fractures.
Highlights
Bisphosphonates inhibit bone resorption, increase bone density, and help prevent fractures, and are widely used for the treatment of osteoporosis
We describe three cases of bisphosphonate-associated incomplete atypical femoral fractures treated by prophylactic intramedullary nail fixation with and without teriparatide administration
The time required for synostosis was 15 months in Case 1, six months in Case 2, and five months in Case 3. These findings suggest that teriparatide administration may shorten the fracture healing period after bisphosphonate-associated incomplete atypical femoral fracture
Summary
Bisphosphonates inhibit bone resorption, increase bone density, and help prevent fractures, and are widely used for the treatment of osteoporosis. A 72-year-old woman underwent left high tibial osteotomy and right total knee arthroplasty (TKA) due to knee osteoarthritis at another hospital She has been taking alendronate (35 mg/week orally) for the treatment of osteoporosis for 41 months. An 88-year-old woman had undergone bilateral TKA in our department and had been taking alendronate (35 mg/week orally) for the past 50 months for osteoporosis She experienced unexplained pain in the left thigh and weakness of the left leg but was ambulatory at our outpatient unit. He had suffered a right femoral neck fracture in a fall four years previously, which was fixed with pins He was started on alendronate at a dose of 35 mg/week orally postoperatively for osteoporosis, and the pins were removed 41 months later. Bone metabolic marker levels rose (P1NP: 74.4 μg/l, TRACP-5b: 363 mU/dl) after a year of daily teriparatide injections
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
