Bisphosphonate Use Raises Risk for Atypical Femoral Fracture

Bisphosphonate use may have a paradoxical effect of adversely affecting bone architecture, thereby raising risk for atypical femoral fractures. In this retrospective Swiss case-control study, researchers explored this relation using data from a single trauma center that captured 95% of all femoral fractures in Geneva. Between 1999 and 2009, 477 patients with subtrochanteric or femoral shaft fractures were identified; 39 had atypical fractures (defined as a transverse or short oblique fracture rather than a typical oblique intertrochanteric or shaft fracture).

Of those 39 patients with atypical fractures, 82.1% were using bisphosphonates, compared with 6.4% of those with classic femoral fractures (odds ratio, 67) and 11.5% in a control group …