Atypical insufficiency fracture of the tibia associated with long-term bisphosphonate therapy.
Osteoporosis is a major public health threat affecting millions of individuals in the United States. Bisphosphonate therapy is currently recognized as a first-line treatment of osteoporosis through the inhibition of osteoclast activity. Concerns have been raised about potential oversuppression of bone turnover and the development of atypical skeletal fragility associated with long-term use of bisphosphonates. A number of case reports in the literature have documented atypical insufficiency fractures in patients on long-term bisphosphonate therapy. This case outlines what we believe is the second documented atypical tibial insufficiency fracture in a patient on long-term bisphosphonate therapy, and highlights the need for increased awareness of atypical insufficiency fractures as well as the need for more data concerning the long-term effects of bisphosphonate therapy.
Department of Internal Medicine, College of Medicine, University of South Florida, Tampa, FL 33612, USA. MBreglia@health.usf.edu
Michael D
MD
Breglia
John D
JD
Carter
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D019386:Alendronate / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D015775:Fractures, Stress / Q000139:chemically induced* / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D013978:Tibial Fractures / Q000139:chemically induced* / Q000000981:diagnostic imaging; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D018501:Antirheumatic Agents; D004164:Diphosphonates; D019386:Alendronate