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Updated: May 22, 2026

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Femoral canal obliteration secondary to prolonged alendronate use: a case report
Chin Tat Lim1, Tony Setiobudi, Shamal Das De
1University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore. chin_tat_lim@nuhs.edu.sg
Abstract:
Insufficiency fractures secondary to prolonged alendronate use is due to inhibition of osteoclastic activity and suppressed bone turnover. Complications of fracture fixation include non-union, mal-union, and difficulty in intramedullary nail insertion. We report a technical challenge in intramedullary nailing of an obliterated femoral canal in a patient on long-term bisphosphonate treatment. The fracture site was explored. The medullary canal was re-created by drilling. Patience and caution during drilling and reaming are necessary to avoid iatrogenic fractures.
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