title: The 5-year follow-up of a cortical stress fracture resulting in a spontaneous atypical subtrochanteric femoral fracture in a female patient with severe osteoporosis and bisphosphonate therapy over 15 years.
abstract: Atypical fractures under long term treatment with bisphosphonates (BP) have been reported, although no causal connection has been known. As an explanation the suppression of bone turnover with poor bone metabolism and consequently deterioration of bone microarchitecture has been suggested. In our case we describe retrospectively the course of radiological and clinical changes in a 75 years old female patient who has been treated with oral BP due to postmenopausal osteoporosis over 15 years. After 10 years of treatment she developed a cortical stress fracture in the subtrochanteric region of the femoral shaft, which finally caused a spontaneous atypical subtrochanteric fracture 5 years later.
authors.affiliation: II. Medical Department, KH Barmherzige Schwestern (St. Vincent Hospital), Academic Teaching Hospital, MUW, Vinforce Study Group, Vienna, Austria. judith.haschka@bhs.at
authors.forename: Judith
authors.initials: J
authors.lastname: Haschka
authors.forename: Friederike
authors.initials: F
authors.lastname: Kühne
authors.forename: Christian
authors.initials: C
authors.lastname: Muschitz
authors.forename: Thomas
authors.initials: T
authors.lastname: Pirker
authors.forename: Roland
authors.initials: R
authors.lastname: Kocijan
authors.forename: Christina
authors.initials: C
authors.lastname: Bittighofer
authors.forename: Angela
authors.initials: A
authors.lastname: Trubrich
authors.forename: Heinrich
authors.initials: H
authors.lastname: Resch
mesh_terms: D000368:Aged; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D005264:Femoral Fractures / Q000139:chemically induced*; D005598:Fractures, Spontaneous / Q000139:chemically induced*; D015775:Fractures, Stress / Q000139:chemically induced*; D006801:Humans; D008137:Longitudinal Studies; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy*
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates