Original Articles

Atypical Fractures of the Femur Related to Prolonged Treatment with Bisphosphonates for Osteoporosis

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Click on the icon on the upper right hand side for the article written by Yoav Rosenthal MD, Amir Arami MD, Yona Kosashvili MD, Nir Cohen MD, Eli Sidon MD and Steven Velkes MD.
IMAJ 2014: 16: February: 78-82
Background: Bisphosphonates reduce the overall risk of fractures among patients with osteoporosis, and this beneficial effect is long-lasting. However, since bisphosphonates inhibit bone remodeling, they may enhance the formation and propagation of micro-cracks over time and patients may therefore be prone to atypical fatigue fractures, mainly in the subtrochanteric region and femoral shaft.

Objectives: To present two cases of subtrochanteric fractures related to bisphosphonate treatment and review of the current literature.

Conclusions: Despite the overall beneficial effect of bisphosphonates, further research is required to prevent this significant complication.