J Korean Orthop Assoc.  2018 Jun;53(3):277-282. 10.4055/jkoa.2018.53.3.277.

Atypical Fracture of the Ulna Associated with 3 Years of Bisphosphonate Medication

• Ryu SM
• Yoon DH
• Park SG

• KMID: 2429177
• DOI: http://doi.org/10.4055/jkoa.2018.53.3.277

Abstract

There have been many studies regarding the relationship between long-term use of bisphosphonate and atypical femoral fractures in the literature. However, studies regarding atypical fractures of the upper limbs are severely limited, especially in Korea. Here, we report an atypical fracture of the ulna in a patient with bisphosphonate medication for a relatively short period of 3 years without any history of fractures at other sites.

Keyword

ulna; fracture; osteoporosis

MeSH Terms

Femoral Fractures
Humans
Korea
Osteoporosis
Ulna*
Upper Extremity

Figure

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  Figure 1 Anteroposterior and lateral radiographs show a minimally displaced fracture of the left proximal ulna. Cortical thickening and marginal sclerosis are observed at the transverse fracture line.

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  Figure 2 Sagittal image of computed tomography also shows cortical thickening and marginal sclerosis at the transverse fracture line.

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  Figure 3 Whole body bone scan shows focal hot uptake in the left proximal ulna (arrows) and right femur shaft (arrows). Intravenous injection of the bone scan agent (technetium-99m methoxy diphosphonate) was performed at the right forearm (arrowheads).

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  Figure 4 Lateral radiograph of the right femur shows diffuse cortical thickening and incomplete fracture in the right femoral shaft (arrow).

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  Figure 5 Anteroposterior and lateral radiographs of the left forearm taken postoperatively.

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  Figure 6 (A) Anteroposterior and lateral radiographs of the left forearm taken 1 year postoperatively show bone union of the ulna fracture. (B) Lateral radiograph of the right femur taken 1 year after the initial forearm injury show no definite change (arrow).

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