Long-Term Alendronate Use Not without Consequences?

Abstract EN

A previously unknown side effect of biphosphonate use is emerging.

In a specific patient group on long term biphosphonate therapy stress femur fractures seem to occur.

The typical presentation consists of prodromal pain in the affected leg and/or a discrete cortical thickening on the lateral side of the femur in conventional radiological examination or the presentation with a spontaneous transverse subtrochanteric femur with typical features.

We present three cases of this stress fracture in patients on bisphosphonate therapy.

One of these patients suffered a bilateral femur fracture of the same type.

In our opinion, in patients on bisphosphonate therapy who present with a spontaneous femur fracture, seizing therapy is advisable.

In bilateral cases preventive nailing should be considered.