[Femur fractures caused by long-term bisphosphonate therapy]

There is increasingly more evidence to suggest that spontaneous femur fractures may be an adverse effect of long-term bisphosphonate use. Patients typically present with prodromal thigh pain, cortical thickening on conventional radiographs or present at A&E with a spontaneous transverse subtrochanteric femur fracture with a medial spike. Discontinuation of bisphosphonate therapy is advisable in patients presenting with a spontaneous femur fracture with specific features while using bisphosphonates. The way in which bisphosphonates alter the mechanical properties of bone is as yet unknown.