Long-Term Alendronate Use Not without Consequences?
A previously unknown side effect of biphosphonate use is emerging. In a specific patient group on long term biphosphonate therapy stress femur fractures seem to occur. The typical presentation consists of prodromal pain in the affected leg and/or a discrete cortical thickening on the lateral side of the femur in conventional radiological examination or the presentation with a spontaneous transverse subtrochanteric femur with typical features. We present three cases of this stress fracture in patients on bisphosphonate therapy. One of these patients suffered a bilateral femur fracture of the same type. In our opinion, in patients on bisphosphonate therapy who present with a spontaneous femur fracture, seizing therapy is advisable. In bilateral cases preventive nailing should be considered.
Department of Orthopaedic Surgery, Academic Medical Center, Postbus 22660, 1100 DD Amsterdam, The Netherlands.
M P
MP
Somford
G F A E
GF
Geurts
J W A M
JW
den Teuling
B J W
BJ
Thomassen
W F
WF
Draijer