title: Diaphyseal femur fractures associated with bisphosphonate use.
abstract: OBJECTIVE
  The aim of this study was to investigate the association of bisphosphonate exposure with low-energy, non-articular femur fractures.
  
  
  METHODS
  The electronic records of 106 patients over the age of 55 years who sustained low-energy non-articular femur fractures and were treated within an integrated health system were examined. Patients were identified through a prospective registry and all fractures were classified anatomically. Cases were matched with control patients without fracture, and prescription orders were examined to assess drug exposures. Conditional logistic regression tested for a significant association between bisphosphonate exposure and fracture.
  
  
  RESULTS
  Thirteen of the 106 cases (12%) and 76 of 804 controls (9%) received at least one year of prescriptions for bisphosphonates prior to fracture. Odds ratio for bisphosphonate exposure as a risk factor was 1.52 (95% confidence interval: 0.76 to 3.05), suggesting no statistically significant association (p=0.24). Results were similar when four-year exposure or alendronates only were studied.
  
  
  CONCLUSIONS
  Bisphosphonate exposure was not associated with non-articular femur fracture in this case-control study. We suggest that the majority of low-energy, geriatric femur fractures are not associated with bisphosphonate exposure.
authors.affiliation: Geisinger Center for Health Research, Danville, PA, USA.
authors.forename: Jove
authors.initials: J
authors.lastname: Graham
authors.forename: Kaan
authors.initials: K
authors.lastname: Irgit
authors.forename: Wade R
authors.initials: WR
authors.lastname: Smith
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Bowen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use; D018483:Diaphyses; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005264:Femoral Fractures / Q000139:chemically induced* / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy*; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates