title: Healing of subtrochanteric atypical fractures after strontium ranelate treatment.
abstract: Oral bisphosphonates comprise the most widely prescribed class of antiosteoporotic drugs. Recent reports, however, suggest a link between prolonged bisphosphonate use and atypical low-energy, subtrochanteric fractures. We describe the clinical course of two patient treated for a long term with different bisphosphonates who developed subtrochanteric atypical fractures. They were treated initially with intramedullary rodding without pain disappearance or healing of the fracture. Strontium ranelate, a new orally administered agent for the treatment of osteoporosis, was given to these patients with complete closure of the fracture and pain disappearance after a few months. We conclude that based on the chronology of fracture healing and pain disappearance of our patients and published evidence that strontium ranelate can accelerate fracture healing in a rat model, that strontium ranelate had a positive anabolic effect that contributed to fracture healing that produced the secondary disappearance of pain.
authors.affiliation: Instituto de Investigaciones Metabólicas, Universidad del Salvador, Buenos Aires, Argentina.
authors.forename: Armando Luis
authors.initials: AL
authors.lastname: Negri
authors.forename: Francisco Rodolfo
authors.initials: FR
authors.lastname: Spivacow
keywords: atypical fractures; bisphosphonate; delayed healing; strontium ranelate