Pathological subtrochanteric fracture associated with chronic use of bisphosphonates: case report

Authors

  • Juan Antonio Daccach * Orthopedist and traumatologist. Fellow in reconstructive hip surgery, Hospital Universitario, Fundación Santafé de Bogotá, Bogotá, Colombia.
  • Luis Carlos Morales Orthopedist and traumatologist. Head of the spine section, member of the trauma section Hospital Universitario, Fundación Santafé de Bogotá, Bogotá, Colombia.
  • Camilo Soto Orthopedist and traumatologist. Head of the metabolic bone disease and orthopedic oncology section, Hospital Universitario, Fundación Santafé de Bogotá, Bogotá, Colombia.
  • Adolfo Llinás Orthopedist and traumatologist. Head of the orthopedics department, Hospital Universitario, Fundación Santafé de Bogotá. Bogotá, Colombia. | Banco de Huesos Cosme y Damián, Bogotá, Colombia.

Keywords:

Hip Fracture, Alendronate, Disphosphonates, Femoral Fractures

Abstract

This is the case report of a 65 year old woman that had been taking bisphosphonates (alendronate) for over 10 years after having a total hysterectomy, and the diagnosis of osteopenia. The patient suffers from diffuse proximal thigh pain and eventually suffers a pathological subtrochanteric femoral fracture. Due to the actual literature on this topic, we are able to reach a final diagnosis and it is believed that the chronic use of alendronate could have been the detrimental factor for this fracture to occur and also for the bone to not have healed properly by its interference with bone consolidation. The aim of this case report is to warn orthopaedic surgeons on how the chronic use of bisphosphonates can give way to subtrochanteric fractures and also alter bone healing and consolidation.

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References

Ott SM. Long term safety of bisphosphonates (editorial). J Clin Endocrin Metab 2005; 90: 1897-9.

Cheung R. Sequential non-traumatic femoral shaft fractures in a patient on long term alendronate. Hong Kong Med J 2007; 13: 485-9.

Fleish H. Bisphosphonates: mechanism of action. Endocr Rev 1998; 19: 80-100.

Boivin GY. Alendronate increases bone strength by increasing the mean degree of mineralization of bone tissue in osteoporotic women. Bone 2000; 27: 687-94.

Odvina C. Severely suppressed bone turnover: a potential complication of alendronate therapy. J of Clin Endocr Metab 2005; 90(3): 1294-301.

Gehrig L. Osteoporosis: management and treatment. Strategies for orthopaedic surgeons. J Bone Joint Surg Am 2008; 90A(6): 1362-73.

Kwek EB. An emerging pattern of subtrochanteric stress fractures. A long term complication of alendronate therapy? Injury 2008; 39(2):224-31.

Neviaser A. Low energy femoral shaft fractures associated with alendronate use. J Orthop Trauma 2008; 22(5): 346-50.

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Published

2011-03-01

How to Cite

1.
Daccach JA, Morales LC, Soto C, Llinás A. Pathological subtrochanteric fracture associated with chronic use of bisphosphonates: case report. Rev. Colomb. Ortop. Traumatol. [Internet]. 2011 Mar. 1 [cited 2026 Mar. 16];25(1):59-63. Available from: https://revistasccotorg.biteca.online/index.php/rccot/article/view/692

Issue

Vol. 25 No. 1 (2011)

Section

Case report

License

Copyright (c) 2025 Sociedad Colombiana de Ortopedia y Traumatología

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

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