Journal of Orthopaedic Science

, Volume 16, Issue 4, pp 467–470 | Cite as

Simultaneous bilateral subtrochanteric fractures following risedronate therapy

  • Mikko T. Ovaska
  • Tatu J. Mäkinen
  • Rami Madanat
Case report


  1. 1.
    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. Effects of continuing or stopping aledronate after 5 years of treatment: the Fracture Intervention Trail Long-term Extension (FLEX): a randomized trail. JAMA. 2006;296:2927–38.PubMedCrossRefGoogle Scholar
  2. 2.
    Mashiba T, Turner CH, Hirano T, Forwood MR, Johnston CC, Burr DB. Effects of suppressed bone turnover by bisphosphonates on microdamage accumulation and biomechanical properties in clinically relevant skeletal sites in beagles. Bone. 2001;28:524–31.PubMedCrossRefGoogle Scholar
  3. 3.
    Odvina CV, Zerwekh JE, Rao DS, Maalouf N, Gottschalk FA, Pak CYC. Severely suppressed bone turnover: a potential complication of alendronate therapy. J Clin Endocrinol Metab. 2005;90:1294–301.PubMedCrossRefGoogle Scholar
  4. 4.
    Capeci CM, Tejwani NC. Bilateral low-energy simultaneous or sequential femoral fractures in patients on long-term alendronate therapy. J Bone Joint Surg Am. 2009;91:2556–61.PubMedCrossRefGoogle Scholar
  5. 5.
    Cermak K, Shumelinsky F, Alexiou J, Gebhart MJ. Case reports: subtrochanteric femoral stress fractures after prolonged alendronate therapy. Clin Orthop Relat Res. 2010;468:1991–6.PubMedCrossRefGoogle Scholar
  6. 6.
    Goh SK, Yang KY, Koh JS, Wong MK, Chua SY, Chua DT, Howe TS. Subtrochanteric insufficiency fractures in patients on alendronate therapy: a caution. J Bone Joint Surg Br. 2007;89:349–53.PubMedCrossRefGoogle Scholar
  7. 7.
    Kwek EB, Goh SK, Koh JS, Png MA, Howe TS. An emerging pattern of subtrochanteric stress fractures: a long-term complication of alendronate therapy? Injury. 2008;39:224–31.PubMedCrossRefGoogle Scholar
  8. 8.
    Lenart BA, Neviaser AS, Lyman S, Chang CC, Edobar-Osula F, Steele B, van der Meulen MC, Lorich DG, Lane JM. Association of low-energy femoral fractures with prolonged bisphosphonate use: a case control study. Osteoporosis Int. 2009;20:1353–62.CrossRefGoogle Scholar
  9. 9.
    Neviaser AS, Lane JM, Lenart BA, Edobor-Osula F, Lorich DG. Low-energy femoral shaft fractures associated with alendronate use. J Orthop Trauma. 2008;22:346–50.PubMedCrossRefGoogle Scholar
  10. 10.
    Sayed-Noor AS, Sjöden GO. Subtrochanteric displaced insufficiency fracture after long-term alendronate therapy—a case report. Acta Orthop. 2008;79:565–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Sayed-Noor AS, Sjöden GO. Case reports: two femoral insufficiency fractures after long-term alendronate therapy. Clin Orthop Relat Res. 2009;467:1921–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Black DM, Kelly MP, Genant HK, Palermo L, Eastell R, Bucci-Rechtweg C, Cayley J, Leung PC, Boonen S, Santora A, de Papp A, Bauer DC. The fracture intervention trial and HORIZON pivotal fracture trail streering committee. N Engl J Med. 2010;362:1761–71.PubMedCrossRefGoogle Scholar
  13. 13.
    Shane E. Evolving data about subtrochanteric fractures and bisphosphonates. N Engl J Med. 2010;362:1825–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Koh JS, Goh SK, Png MA, Kwek EB, Howe TS. Femoral cortical stress lesions in long-term bisphosphonate therapy: a herald of impending fracture? J Orthop Trauma. 2010;24:75–81.PubMedCrossRefGoogle Scholar
  15. 15.
    Schilcher J, Aspenberg P. Incidence of stress fractures of the femoral shaft in women treated with bisphosphonate. Acta Orthop. 2009;80:413–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Lenart BA, Lorich DG, Lane JM. Atypical fractures of the femoral diaphysis in postmenopausal women taking alendronate. N Engl J Med. 2008;358:1304–6.PubMedCrossRefGoogle Scholar
  17. 17.
    Somford MP, Draijer FW, Thomassen BJW, Chavassieux PM, Boivin G, Papapoulus SE. Clinical vignette. 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. 2009;24:1736–40.PubMedCrossRefGoogle Scholar
  18. 18.
    Ingle BM, Hay SM, Bottjer HM, Eastell R. Changes in bone mass and bone turnover following distal forearm fracture. Osteoporosis Int. 1999;10:399–407.CrossRefGoogle Scholar
  19. 19.
    Visekruna M, Wilson D, McKiernan FE. Severely suppressed bone turnover and atypical skeletal fragility. J Clin Endocrinol Metab. 2008;93:2948–52.PubMedCrossRefGoogle Scholar
  20. 20.
    Kanis JA, Johansson H, Oden A, Johnell O, de Laet C, Melton LJ III, Tenenhouse A, Reeve J, Silman AJ, Pols HAP, Eisman JA, McCloskey EV, Mellstrom D. A meta-analysis of prior corticosteroid use and fracture risk. J Bone Miner Res. 2004;19:893–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Aspenberg P. Bisphosphonate-induced fractures: nature strikes back? Acta Orthop. 2008;79:459–60.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Orthopaedic Association 2011

Authors and Affiliations

  • Mikko T. Ovaska
    • 1
  • Tatu J. Mäkinen
    • 1
  • Rami Madanat
    • 1
  1. 1.Department of SurgeryPäijät-Häme Central HospitalLahtiFinland

Personalised recommendations