Femur fracture associated with bisphosphonate use

Abstract

Bisphosphonates are widely used drugs to improve bone mineral density and prevent bone loss. Despite the short-term efficacy, safety of long-term therapy is debated. These drugs can have harmful effects on the physiology of bone, because bone turnover is deleted. A case of a 73 year-old female patient who presented bilateral atypical femur fracture, of pathological mechanism associated with prolonged use of bisphosphonates is reported, describing typical symptoms and radiological signs. Surgery was performed with intramedullary Kuntscher type nailing, with good clinical and radiological follow-up for one year. The possibility of impending fracture in bisphosphonate consumers for prolonged periods with previous thigh pain should put physicians on alert and require searching for characteristic radiological signs. The prophylactic fixation may be raised in these cases. In conclusion, this is a rare case of pathological fracture of the femur associated with bisphosphonate prolonged use with good results after surgical treatment.