title: [Atypical femoral fractures associated with long-term treatment with bisphosphonates].
abstract: BACKGROUND
  Long-term treatment with bisphosphonates has been associated to atypical femoral fractures whose features are now clearly defined.
  
  
  METHODS
  We present two cases of female patients under bisphosphonate treatment for over 10 years who were admitted to our institution for subtrochanteric and femoral shaft fractures after low-energy trauma. They presented, respectively, a transverse and a short oblique femoral fracture, with thickening of the lateral cortex. They underwent surgical treatment obtaining good functional and imaging result.
  
  
  CONCLUSIONS
  These cases fulfill the established criteria for atypical femoral fracture, thereby illustrating a serious adverse event of long-term treatment with bisphosphonates. Such relationship has still not been clearly established by scientific evidence. However, its effectiveness in preventing osteoporotic fractures is well proven.
  
  
  CONCLUSIONS
  The atypical femoral fractures are possibly a serious adverse effect of the long-term treatment with bisphosphonates. Scientific evidence still supports its use, however, the physician must be aware of these events and closely follow-up these patients.
authors.affiliation: Serviço de Ortopedia. Hospital Fernando Fonseca. Amadora. Portugal.
authors.forename: Francisco
authors.initials: F
authors.lastname: Flores Santos
authors.affiliation: Serviço de Ortopedia. Hospital Força Aérea. Lisboa. Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Pinheiro da Silva
authors.affiliation: Serviço de Ortopedia. Hospital Fernando Fonseca. Amadora. Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Felicíssimo
mesh_terms: D000368:Aged; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005264:Femoral Fractures / Q000139:chemically induced*; D006801:Humans; D008875:Middle Aged; D013997:Time Factors
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates