Ann Rehabil Med.  2013 Jun;37(3):430-432. 10.5535/arm.2013.37.3.430.

A Case Report of Long-Term Bisphosphonate Therapy and Atypical Stress Fracture of Bilateral Femur

• Jo YR
• Kim HW
• Moon SH
• Ko YJ

• KMID: 2219542
• DOI: http://doi.org/10.5535/arm.2013.37.3.430

Abstract

Bisphosphonates are potent inhibitors of bone resorption and considered as a gold standard and are generally recommended as first-line therapy in patients with osteoporosis. Though bisphosphonates are shown to significantly reduce the risk of vertebral, non-vertebral and hip fractures, recent reports suggest a possible correlation between long-term bisphosphonate therapy and the occurrence of insufficiency fractures owing to prolonged bone turnover suppression. We report a patient with non-traumatic stress fractures of bilateral femoral shafts related to long-term bisphosphonate therapy indicating the need for a critical evaluation of patients with long-term bisphosphonate therapy.

Keyword

Osteoporosis; Bisphosphonates; Stress fracture

MeSH Terms

Bone Resorption
Diphosphonates
Femur
Fractures, Stress
Hip Fractures
Humans
Osteoporosis
Diphosphonates

Figure

• 

  Fig. 1 Plain radiograph of both femurs. Linear fracture line with lateral cortex thickening in right mid shaft is suggestive of stress fracture. Only lateral cortex thickening was shown in left side.

• 

  Fig. 2 Whole body bone scan image. Focal hot uptakes are noted in lateral cortex of mid shafts of bilateral femurs.

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  Fig. 3 A plate and screws fixation of the right femoral shaft and an intramedullary nailing, and cables fixation in the left side.

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