Bisphosphonates and Fractures of the Subtrochanteric or Diaphyseal Femur

Recent case reports and series have identified a subgroup of atypical femoral-shaft fractures associated with bisphosphonate use. This study analyzed data from three large, randomized bisphosphonate trials. Subtrochanteric or diaphyseal femur fractures were very rare, even among women who had been treated with bisphosphonates for as long as 10 years. In patients with osteoporosis, proven benefits for fracture reduction appear to outweigh the possible risk of femoral-shaft fractures. This study analyzed data from three large, randomized bisphosphonate trials. Subtrochanteric or diaphyseal femur fractures were very rare, even among women who had been treated with bisphosphonates for as long as 10 years. Several case series have described cases of “atypical” subtrochanteric and diaphyseal fractures of the femoral shaft and have suggested that the risk may be increased in long-term users of bisphosphonates. 1 – 13 Descriptions of associated atypical characteristics vary but have been described as a simple transverse or oblique (