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Bisphosphonate drugs (alendronate, risedronate, and others) are typically prescribed to prevent osteoporotic hip fractures involving the femoral neck or intertrochanteric region. However, several small case series show that long-term users of bisphosphonates could be at excess risk for subtrochanteric or femoral shaft fractures with atypical characteristics, including transverse orientation and thickening of the cortex at the fracture site (see image). In addition, these fractures sometimes are “low-energy” (i.e., not associated with trauma) and preceded by prodromal thigh pain. The incidence of bisphosphonate-associated femur fractures has been unclear, but two large studies published in 2011 shed some light on the matter.
In a population-b…
