Skip to main content
Top
Published in: European Journal of Orthopaedic Surgery & Traumatology 2/2013

01-11-2013 | Up-to date Review and Case Report

Atypical bilateral femoral shaft fracture in patient treated with bisphosphonates

Authors: Raúl Parrón Cambero, Antonio Rey López, Félix Tomé-Bermejo, Roberto Cibantos Martínez

Published in: European Journal of Orthopaedic Surgery & Traumatology | Special Issue 2/2013

Login to get access

Abstract

We report a patient with previous history of long-term bisphosphonate intake who suffered the fracture of both femurs consecutively. The radiological characteristics of both fractures allowed to catalog a posteriori of atypical fractures associated with the prolonged treatment with bisphosphonates. Atypical fractures represent an entity of recent definition that in the last years have attracted considerable attention due to the publication of an increasing number of cases. The aim of this paper is to emphasize the importance of its clinical suspicion before they appear and the characteristics of this type of fractures to provide the most appropriate clinical and surgical treatment.
Literature
1.
go back to reference Whyte MP (2009) Atypical femoral fractures, bisphosphonates, and adult hypophosphatasia. J Bone Miner Res 24:1132–1134PubMedCrossRef Whyte MP (2009) Atypical femoral fractures, bisphosphonates, and adult hypophosphatasia. J Bone Miner Res 24:1132–1134PubMedCrossRef
2.
go back to reference Kwek EB, Goh SK, Koh JS, Png MA, Howe TS (2008) An emerging pattern of subtrochanteric stress fractures: a long-term complication of alendronate therapy? Injury 39:224–231PubMedCrossRef Kwek EB, Goh SK, Koh JS, Png MA, Howe TS (2008) An emerging pattern of subtrochanteric stress fractures: a long-term complication of alendronate therapy? Injury 39:224–231PubMedCrossRef
3.
go back to reference Lenart BA, Neviaser AS, Lyman S et al (2009) Association of low-energy femoral fractures with prolonged bisphosphonate use: a case control study. Osteoporos Int 20:1353–1362PubMedCrossRef Lenart BA, Neviaser AS, Lyman S et al (2009) Association of low-energy femoral fractures with prolonged bisphosphonate use: a case control study. Osteoporos Int 20:1353–1362PubMedCrossRef
4.
go back to reference Schilcher J, Aspenberg P (2009) Incidence of stress fractures of the femoral shaft in women treated with bisphosphonate. Acta Orthop. 80:413–415PubMedCrossRef Schilcher J, Aspenberg P (2009) Incidence of stress fractures of the femoral shaft in women treated with bisphosphonate. Acta Orthop. 80:413–415PubMedCrossRef
5.
go back to reference 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 25:2267–2294PubMedCrossRef 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 25:2267–2294PubMedCrossRef
6.
go back to reference Girgis CM, Sher D, Seibel MJ (2010) Atypical femoral fractures and bisphosphonate use. N Engl J Med 362:1848–1849PubMedCrossRef Girgis CM, Sher D, Seibel MJ (2010) Atypical femoral fractures and bisphosphonate use. N Engl J Med 362:1848–1849PubMedCrossRef
7.
go back to reference Isacs JD, Shidiak L, Harris I (2010) Femoral insufficiency fractures associated with prologned alendronate therapy. In: Annual meeting of the American Academy of Orthopedic Surgeons, New Orleans, LA, USA Isacs JD, Shidiak L, Harris I (2010) Femoral insufficiency fractures associated with prologned alendronate therapy. In: Annual meeting of the American Academy of Orthopedic Surgeons, New Orleans, LA, USA
8.
go back to reference 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 91:2556–2561PubMedCrossRef 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 91:2556–2561PubMedCrossRef
9.
go back to reference Cermak K, Shumelinsky F, Alexiou J, Gebhart MJ (2009) Case reports: subtrochanteric femoral stress fractures after prolonged alendronate therapy. Clin Orthop Relat Res 468:1991–1996PubMedCrossRef Cermak K, Shumelinsky F, Alexiou J, Gebhart MJ (2009) Case reports: subtrochanteric femoral stress fractures after prolonged alendronate therapy. Clin Orthop Relat Res 468:1991–1996PubMedCrossRef
10.
go back to reference 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 24:1736–1740PubMedCrossRef 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 24:1736–1740PubMedCrossRef
11.
go back to reference Leung F, Lau TW, To M, Luk KDK, Kung AWC (2009) Atypical femoral diaphyseal and subtrochanteric fractures and their association with bisphosphonates. BMJ Case Rep 5:1073 Leung F, Lau TW, To M, Luk KDK, Kung AWC (2009) Atypical femoral diaphyseal and subtrochanteric fractures and their association with bisphosphonates. BMJ Case Rep 5:1073
12.
go back to reference De Das S, Setiobudi T, Shen L (2009) A rational approach to management of alendronate-related subtrochanteric fractures. J Bone Joint Surg Br 92:679–686 De Das S, Setiobudi T, Shen L (2009) A rational approach to management of alendronate-related subtrochanteric fractures. J Bone Joint Surg Br 92:679–686
13.
go back to reference Goh SK, Yang KY, Koh JS et al (2007) Subtrochanteric insufficiency fractures in patients on alendronate therapy: a caution. J Bone Joint Surg Br 89:349–353PubMed Goh SK, Yang KY, Koh JS et al (2007) Subtrochanteric insufficiency fractures in patients on alendronate therapy: a caution. J Bone Joint Surg Br 89:349–353PubMed
14.
go back to reference Lenart BA, Lorich DG, Lane JM (2008) Atypical fractures of the femoral diaphysis in postmenopausal women taking alendronate. N Engl J Med 358:1304–1306PubMedCrossRef Lenart BA, Lorich DG, Lane JM (2008) Atypical fractures of the femoral diaphysis in postmenopausal women taking alendronate. N Engl J Med 358:1304–1306PubMedCrossRef
15.
go back to reference Sayed-Noor AS, Sjoden GO (2009) Case reports: two femoral insufficiency fractures after long-term alendronate therapy. Clin Orthop Relat Res 467:1921–1926PubMedCrossRef Sayed-Noor AS, Sjoden GO (2009) Case reports: two femoral insufficiency fractures after long-term alendronate therapy. Clin Orthop Relat Res 467:1921–1926PubMedCrossRef
16.
go back to reference Aspenberg P, Genant HK, Johansson T et al (2010) Teriparatide for acceleration of fracture repair in humans: a prospective, randomized, double-blind study of 102 postmenopausal women with distal radial fractures. J Bone Miner Res 25:404–414PubMedCrossRef Aspenberg P, Genant HK, Johansson T et al (2010) Teriparatide for acceleration of fracture repair in humans: a prospective, randomized, double-blind study of 102 postmenopausal women with distal radial fractures. J Bone Miner Res 25:404–414PubMedCrossRef
17.
go back to reference Caeiro-Rey JR, Etxebarria-Foronda I, Mesa-Ramos M (2011) Fracturas atípicas relacionadas con el uso prolongado de bifosfonatos. Estado de la situación. (Atypical fractures associated with prolonged use of bisphosphonates. Situation status). Rev Esp Cir Ortop Traumatol 55(5):392–404 Caeiro-Rey JR, Etxebarria-Foronda I, Mesa-Ramos M (2011) Fracturas atípicas relacionadas con el uso prolongado de bifosfonatos. Estado de la situación. (Atypical fractures associated with prolonged use of bisphosphonates. Situation status). Rev Esp Cir Ortop Traumatol 55(5):392–404
Metadata
Title
Atypical bilateral femoral shaft fracture in patient treated with bisphosphonates
Authors
Raúl Parrón Cambero
Antonio Rey López
Félix Tomé-Bermejo
Roberto Cibantos Martínez
Publication date
01-11-2013
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue Special Issue 2/2013
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-012-1086-9

Other articles of this Special Issue 2/2013

European Journal of Orthopaedic Surgery & Traumatology 2/2013 Go to the issue