title: Bisphosphonate long-term treatment related bilateral subtrochanteric femoral fracture. Can teriparatide be useful?
abstract: Long-term treatment with bisphosphonates has been related to atypical femoral fractures. We report the clinical case of a woman who suffered a proximal diaphyseal oblique fracture of the left femur after uninterrupted 13-year treatment with alendronate. Shortly after surgery, a painful lytic image in the external cortex of her right femur diaphysis was detected. Some papers have suggested surgical treatment to repair femur fractures after long-term treatment with bisphosphonates. Otherwise, two studies have shown healing acceleration of bone fractures with teriparatide. A lytic lesion was treated with teriparatide obtaining progressive disappearance of symptoms as well as bone healing. This outcome may suggest a way of prevention of complete fractures in symptomatic patients with long-term treatment with bisphosphonates.
authors.affiliation: Geriatric Medicine Deparment, Hospital Universitario de la Ribera, Carretera de Corbera nº 1, 46600, Alzira, Valencia, Spain, fjtarazona@hospital-ribera.com.
authors.forename: Francisco José
authors.initials: FJ
authors.lastname: Tarazona-Santabalbina
authors.forename: Luis
authors.initials: L
authors.lastname: Aguilella-Fernández
mesh_terms: D019386:Alendronate / Q000009:adverse effects / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005264:Femoral Fractures / Q000139:chemically induced* / Q000188:drug therapy*; D005269:Femur / Q000187:drug effects; D006801:Humans; D019379:Teriparatide / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D019379:Teriparatide; D019386:Alendronate