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Although bisphosphonates lower overall risk for fractures in women with osteoporosis, an unusual type of femoral fracture has been described in a few long-term bisphosphonate users (see accompanying image). Two reports provide additional information.
In a case series, orthopedists at New York University describe seven women on long-term alendronate therapy (average duration, 9 years) who sustained sequential or simultaneous bilateral femoral “low-energy” fractures (i.e., resulting from falls from standing height or lower). All fractures were subtrochanteric or involved the femoral shaft, unlike typical femoral fractures that involve the intertrochanteric or femoral neck regions. These fractures each had a unique appearance, with a spike or b…
