title: Progression of bisphosphonate-associated impending atypical femoral fracture despite prophylactic cephalomedullary nailing: A case report and review of literature.
abstract: While bisphosphonates have been shown to be effective in reducing the incidence of typical osteoporotic fractures, long-term bisphosphonate may be associated with atypical femoral fractures. We report a case of a bisphosphonate-related impending atypical femoral fracture which progressed despite prophylactic cephalomedullary nailing. The fracture healed without further surgical intervention after correcting the patient's bone metabolic profile and stopping the possible offending factors. Although prophylactic fixation of these fractures is recommended, our case and relevant literature review demonstrate that a simple fixation without optimizing other possible predisposing factors may not prevent progression of these fractures.
authors.affiliation: SUNY Downstate Medical Center, Department of Orthopaedic Surgery and Rehabilitation, Brooklyn, NY, United States.
authors.forename: Aditya V
authors.initials: AV
authors.lastname: Maheshwari
authors.affiliation: SUNY Downstate Medical Center, Department of Orthopaedic Surgery and Rehabilitation, Brooklyn, NY, United States.
authors.forename: Samantha J
authors.initials: SJ
authors.lastname: Yarmis
authors.affiliation: SUNY Downstate Medical Center, Department of Orthopaedic Surgery and Rehabilitation, Brooklyn, NY, United States.
authors.forename: Justin
authors.initials: J
authors.lastname: Tsai
authors.affiliation: SUNY Downstate Medical Center, Department of Orthopaedic Surgery and Rehabilitation, Brooklyn, NY, United States.
authors.forename: Julio J
authors.initials: JJ
authors.lastname: Jauregui
keywords: Atypical femur fractures; Bisphosphonate associated fractures; Bisphosphonates; Pathologic fractures; Stress fractures