Introduction. Although bisphosphonates represent the most commonly
prescribed antiresorptive therapy for the treatment of osteoporosis and
fracture prevention, paradoxically, their continuous use in some patients
can lead to an atypical femoral fracture. This type of fracture is
characterized by specific features regarding clinical presentation,
mechanism of injury and radiological manifestations. The objective of this
article was to present a case of a bilateral femoral fracture associated
with bisphosphonate usage. Case outline. A seventy-year-old female patient
was presented to the emergency department with a severe, throbbing pain in
both thighs after a ground-level fall. Radiographs of both femurs verified
bilateral complete fracture localized in the diaphyseal region. Prior to the
hospitalization, she was continuously taking ibandronate for three years.
The patient underwent percutaneous osteosynthesis with intramedullary
nailing with interlocking screws of both femurs. Six weeks after surgical
treatment, radiographic findings indicated the presence of early signs of
healing on both femurs. At four months follow up, the complete union of the
bone fragments was achieved and she managed to walk without any pain and
walking aids. Conclusion. Physicians still face doubts regarding optimal
duration of bisphosphonate therapy. Although atypical femoral fracture
represents a rare adverse event related to bisphosphonate use, all patients
receiving this antiresorptive treatment who are complaining of new-onset
unexplained pain in the thighs for more than two weeks should be completely
diagnostically evaluated in term of atypical femoral fracture. Patients with
confirmed atypical femoral fracture should undergo surgical treatment
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.