Bilateral Simultaneous Femoral Fragility Fractures after Long - Term Alendronate Therapy

Yalcin Turhan Department of Orthopaedics and Traumatology, School of Medicine, Duzce University, Duzce, Turkey. e-mail: yturhan_2000@yahoo.com INTRODUCTION Osteoporosis is a major public health problem with a significant economic burden on the society (1–4). The main clinical manifestations of osteoporosis are low-energy fractures of the proximal femur, vertebrae, and distal radius. Nearly two million osteoporotic fractures occur annually in the United States at an estimated cost of more than $17 billion (5,6). Subtrochanteric and diaphyseal areas are considered to be the strongest parts of femur subjected to the highest stresses of the body (7). The strongest bone of the body, femur diaphysis, is an unusual site for fracture due to minor trauma, and raises significant suspicion regarding the pathogenesis of the fracture. In recent years, some cases of subtrochanteric and diaphyseal fractures due to minor trauma have been reported in association with long-term alendronate therapy (8-10). This pattern of fracture is defined as alendronate-induced atypical fracture. This study presents a case of bilateral femoral insufficiency fracture in a woman receiving long-term alendronate therapy.