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Updated: Jun 3, 2026
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Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
[Bilateral pathological sub-trochanteric fracture in a long-term biphosphonate user]
1Klinika úrazovej chirurgie FNsP J. A. Reimana a Fakulta zdravotníctva Prešovskej univerzity, Prešov, Slovenská republika.
Summary
Long-term bisphosphonate use can lead to rare pathological fractures, often bilateral, occurring 2-8 years into treatment. This case highlights delayed healing and non-union complications in a patient using Rizendronat.
Area of Science:
- Orthopedics
- Pharmacology
- Radiology
Background:
- Bisphosphonates are widely used to treat osteoporosis and prevent fractures.
- Long-term use has been associated with an increase in atypical stress fractures.
- These fractures present unique radiological and clinical characteristics.
Observation:
- A case study of a female patient on long-term Rizendronat therapy for 9 years.
- The patient experienced bilateral sub-trochanteric pathological fractures after 5 and 9 years of use.
- Prodromal hip pain and MRI findings indicated pathological changes prior to fracture.
Findings:
- The fractures were surgically treated, but the patient developed pseudoarthrosis and non-union.
- The first fracture site required revision surgery for pseudoarthrosis, which healed. The second fracture showed non-union at 7 months.
- The patient continued Rizendronat use throughout the treatment and follow-up period.
Implications:
- This case underscores the potential for severe complications like non-union and pseudoarthrosis with long-term bisphosphonate use.
- Early diagnosis and intervention may be crucial for managing these rare fractures.
- Further research into preventive, diagnostic, and therapeutic strategies for bisphosphonate-associated fractures is warranted.
