Atypical femoral fractures in association with bisphosphonate therapy: a case series

Well-established clinically as frontline therapy in the management of osteoporosis, bisphosphonates have been shown in numerous trials to be highly effective in reducing the risk of both vertebral and hip fractures. More recently, however, in a multitude of exhaustive case reviews, attention has been raised to the small but by now well-established link between prolonged bisphosphonate usage and the risk for atypical subtrochanteric femoral stress fractures. We present herein a trio of illustrative cases highlighting both clinical presentation and characteristic radiological findings thereof, as well as a discussion of the background, management, and natural history of these oftentimes problematic injuries.