Skip to main content

Advertisement

SpringerLink
Log in

Low-energy femoral stress fracture in long-term bisphosphonate use: conservative and surgical treatment

  • Case Report
  • Published:
European Orthopaedics and Traumatology

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11

References

  1. Cermak K, Shumelinsky F, Alexiou J, Gebhart MJ (2010) Case reports: subtrochanteric femoral stress fractures after prolonged alendronate therapy. Clin Orthop Relat Res 468(7):1991–6

    Article  PubMed Central  PubMed  Google Scholar 

  2. De Das S, Setiobudi T, Shen L, De Das S (2010) A rational approach to management of alendronate-related subtrochanteric fractures. J Bone Joint Surg Br 92(5):679–86

    Article  Google Scholar 

  3. Black DM, Schwartz AV, Ensrud KE, Cauley JA, Levis S, Quandt SA, Satterfield S, Wallace RB, Bauer DC, Palermo L, Wehren LE, Lombardi A, Santora AC, Cummings SR, FLEX Research Group (2006) Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Longterm Extension (FLEX): a randomized trial. JAMA 296:2927–2938

    Article  CAS  PubMed  Google Scholar 

  4. Abrahamsen B (2010) Adverse effects of bisphosphonates. Calcif Tissue Int 86:421–435

    Article  CAS  PubMed  Google Scholar 

  5. Mashiba T, Turner CH, Hirano T, Forwood MR, Johnston CC, Burr DB (2001) Effects of suppressed bone turnover by bisphosphonates on microdamage accumulation and biomechanical properties in clinically relevant skeletal sites in beagles. Bone 28:524–531

    Article  CAS  PubMed  Google Scholar 

  6. Neviaser AS, Lane JM, Lenart BA, Edobor-Osula F, Lorich DG (2008) Low-energy femoral shaft fractures associated with alendronate use. J Orthop Trauma 22(5):346–350

    Article  PubMed  Google Scholar 

  7. Lenart BA, Neviaser AS, Lyman S, Chang CC, Edobor-Osula F, Steele B, van der Meulen MC, Lorich DG, Lane JM (2009) Association of low-energy femoral fractures with prolonged bisphosphonate use: a case control study. Osteoporos Int 20(8):1353–62

    Article  CAS  PubMed  Google Scholar 

  8. Nieves JW, Cosman F (2010) Atypical subtrochanteric and femoral shaft fractures and possible association with bisphosphonates. Curr Osteoporos Rep 8(1):34–9

    Article  PubMed  Google Scholar 

  9. Goddard MS, Reid KR, Johnston JC, Khanuja HS (2009) Atraumatic bilateral femur fracture in long-term bisphosphonate use. Orthopedics 32(8)

  10. Capeci CM, Tejwani NC (2009) Bilateral low-energy simultaneous or sequential femoral fractures in patients on long-term alendronate therapy. J Bone Joint Surg Am 91(11):2556–61

    Article  PubMed  Google Scholar 

  11. Husada G, Libberecht K, Peeters T, Populaire J (2005) Bilateral mid-diaphyseal femoral stress fractures in the elderly. Eur J Trauma 31:68–71

    Article  Google Scholar 

  12. Lee P, van der Wall H, Seibel MJ (2007) Looking beyond low bone mineral density: multiple insufficiency fractures in a woman with post-menopausal osteoporosis on alendronate therapy. J Endocrinol Invest 30:590–597

    CAS  PubMed  Google Scholar 

  13. Black DM, Thompson DE, Bauer DC, Ensrud K, Musliner T, Hochberg MC, Nevitt MC, Suryawanshi S, Cummings SR (2000) Fracture risk reduction with alendronate in women with osteoporosis: The Fracture Intervention Trial. J Clin Endocrinol Metab 85(11):4118–24

    Article  CAS  PubMed  Google Scholar 

  14. Odvina CV, Zerwekh JE, Rao DS, Maalouf N, Gottschalk FA, Pak CYC (2005) Severely suppressed bone turnover: a potential complication of alendronate therapy. J Clin Endocrinol Metab 90(3):1294–1301

    Article  CAS  PubMed  Google Scholar 

  15. Koh JS, Goh SK, Png MA, Kwek EB, Howe TS (2010) Femoral cortical stress lesions in long-term bisphosphonate therapy: a herald of impending fracture? J Orthop Trauma 24:75–81

    Article  PubMed  Google Scholar 

  16. Somford MP, Draijer FW, Thomassen BJ, Chavassieux PM, Boivin G, Papapoulos SE (2009) Bilateral fractures of the femur diaphysis in a patient with rheumatoid arthritis on long-term treatment with alendronate: clues to the mechanism of increased bone fragility. J Bone Miner Res 24(10):1736–40

    Article  PubMed  Google Scholar 

  17. Ahn JK, Lee J, Cha HS, Koh EM (2011) Non-traumatic fracture of the femoral shaft in a patient taking long-term bisphosphonate therapy. Rheumatol Int 31(7):973–5

    Article  PubMed  Google Scholar 

  18. Napoli N, Novack D, Armamento-Villareal R (2010) Bisphosphonate-associated femoral fracture: implications for management in patients with malignancies. Osteoporos Int 21(4):705–8

    Article  CAS  PubMed  Google Scholar 

  19. Venkatanarasimha N, Miles G, Suresh P (2010) Subtrochanteric femoral insufficiency fractures related to the use of long-term bisphosphonates: a pictorial review. Emerg Radiol 17(6):511–5

    Article  PubMed  Google Scholar 

  20. Burr DB, Diab T, Koivunemi A, Koivunemi M, Allen MR (2009) Effects of 1 to 3 years’ treatment with alendronate on mechanical properties of the femoral shaft in a canine model: implications for subtrochanteric femoral fracture risk. J Orthop Res 27(10):1288–92

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Schilcher J, Aspenberg P (2009) Incidence of stress fractures of the femoral shaft in women treated with bisphosphonate. Acta Orthop 80(4):413–5

    Article  PubMed Central  PubMed  Google Scholar 

  22. Sayed-Noor AS, Sjödén GO (2009) Case reports: two femoral insufficiency fractures after long-term alendronate therapy. Clin Orthop Relat Res 467(7):1921–6

    Article  PubMed Central  PubMed  Google Scholar 

  23. Atik OS, Suluova F, Görmeli G, Yildirim A, Ali AK (2010) Insufficiency femoral fractures in patients undergoing prolonged alendronate therapy. Eklem Hastalik Cerrahisi 21(1):56–9

    PubMed  Google Scholar 

  24. Visekruna M, Wilson D, McKiernan FE (2008) Severely suppressed bone turnover and atypical skeletal fragility. J Clin Endocrinol Metab 93(8):2948–2952

    Article  CAS  PubMed  Google Scholar 

  25. Cheung RKH, Leung KK, Lee KC, Chow TC (2007) Sequential non-traumatic femoral shaft fractures in a patient on long-term alendronate. Hong Kong Med J 13(6):485–489

    PubMed  Google Scholar 

  26. Goh SK, Yang KY, Koh JS (2007) Subtrochanteric insufficiency fractures in patients on alendronate therapy: a caution. J Bone Joint Surg Br 89:349–353

    Article  PubMed  Google Scholar 

  27. Kwek EBK, Goh SK, Koh JSB, Png MA, Howe TS (2008) An emerging pattern of subtrochanteric stress fractures: a long-term complication of alendronate therapy? Injury 39(2):224–231

    Article  PubMed  Google Scholar 

  28. Park-Wyllie LY, Mamdani MM, Juurlink DN, Hawker GA, Gunraj N, Austin PC, Whelan DB, Weiler PJ, Laupacis A (2011) Bisphosphonate use and the risk of subtrochanteric or femoral shaft fractures in older women. JAMA 305(8):783–9

    Article  CAS  PubMed  Google Scholar 

  29. Isaacs JD, Shidiak L, Harris IA, Szomor ZL (2010) Femoral insufficiency fractures associated with prolonged bisphosphonate therapy. Clin Orthop Relat Res 468(12):3384–92

    Article  PubMed Central  PubMed  Google Scholar 

  30. Weil YA, Rivkin G, Safran O, Liebergall M, Foldes AJ (2011) The outcome of surgically treated femur fractures associated with long-term bisphosphonate use. J Trauma 71(1):186–90

    Article  CAS  PubMed  Google Scholar 

  31. Ha YC, Cho MR, Park KH, Kim SY, Koo KH (2010) Is surgery necessary for femoral insufficiency fractures after long-term bisphosphoante therapy? Clin Orthop Relat Res 468:3393–3398

    Article  PubMed Central  PubMed  Google Scholar 

  32. Banffy MB, Vrahas MS, Ready JE, Abraham JA (2011) Nonoperative versus prophylactic treatment of bisphosphonate-associated femoral stress fractures. Clin Orthop Relat Res 469(7):2028–34

    Article  PubMed Central  PubMed  Google Scholar 

  33. Rizzoli R, Akesson K, Bouxsein M, Kanis JA, Napoli N, Papapoulos S, Reginster JY, Cooper C (2011) Subtrochanteric fractures after long-term treatment with bisphosphonates: a European Society on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, and International Osteoporosis Foundation Working Group Report. Osteoporos Int 22(2):373–90

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  34. Shane E, Burr D, Ebeling PR et al (2010) Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 25:2267–2294

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopaedics and Traumatology Department, Taksim Training and Research Hospital, Istanbul, Turkey

    Fuat Bilgili, Sami Sökücü, Ayhan Kılıç, Atilla Sancar Parmaksızoğlu & Yavuz Selim Kabukçuoğlu

  2. Universal German Hospital, Istanbul, Turkey

    Özgür Mengeş

Authors
  1. Fuat Bilgili
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sami Sökücü
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ayhan Kılıç
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Atilla Sancar Parmaksızoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Özgür Mengeş
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yavuz Selim Kabukçuoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fuat Bilgili.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bilgili, F., Sökücü, S., Kılıç, A. et al. Low-energy femoral stress fracture in long-term bisphosphonate use: conservative and surgical treatment. Eur Orthop Traumatol 5, 15–23 (2014). https://doi.org/10.1007/s12570-013-0206-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12570-013-0206-2

Keywords

Search

Navigation