title: Femoral canal obliteration secondary to prolonged alendronate use: a case report.
abstract: Insufficiency fractures secondary to prolonged alendronate use is due to inhibition of osteoclastic activity and suppressed bone turnover. Complications of fracture fixation include non-union, mal-union, and difficulty in intramedullary nail insertion. We report a technical challenge in intramedullary nailing of an obliterated femoral canal in a patient on long-term bisphosphonate treatment. The fracture site was explored. The medullary canal was re-created by drilling. Patience and caution during drilling and reaming are necessary to avoid iatrogenic fractures.
authors.affiliation: University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore. chin_tat_lim@nuhs.edu.sg
authors.forename: Chin Tat
authors.initials: CT
authors.lastname: Lim
authors.forename: Tony
authors.initials: T
authors.lastname: Setiobudi
authors.forename: Shamal
authors.initials: S
authors.lastname: Das De
mesh_terms: D000369:Aged, 80 and over; D019386:Alendronate / Q000009:adverse effects*; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D005260:Female; D005264:Femoral Fractures / Q000139:chemically induced* / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary; D015775:Fractures, Stress / Q000139:chemically induced* / Q000601:surgery*; D006801:Humans; D013997:Time Factors
chemical_list: D050071:Bone Density Conservation Agents; D019386:Alendronate