Unusual fractures of the femoral shaft produced by bisphosphonates use. Case report

Abstract

There is a growing trend of atypical femur fractures in the current adult population. Treatment with bisphosphonates for more than 5 years may put patients at greater risk. The aim of this report is to demonstrate how surgical treatment with a rigid intramedullary device can maintain the position and length of the femur by improving stability and pain in nondisplaced fractures secondary to the use of bisphosphonates. A review is presented on the clinical case of a 77 year-old patient with moderate pain on walking of 2-months onset that improved with rest. After imaging tests were performed, it was decided to insert a rigid intramedullary device. The subsequent follow-up included a clinical assessment using the Lower Extremity Functional Scale (LEFS). Control X-rays were performed to determine the degree of consolidation during treatment, as well as the suspending of alendronate. Fixation was made with a second-generation gamma intramedullary nail, after which there was periodic monitoring and suspension of alendronate therapy. At 6 months post-operatively, the LEFS was applied, obtaining a 100% result.