Bisphosphonate-induced Atypical Femoral Shaft Fracture

Bisphosphonates are used to treat postmenopausal and glucocorticoid-induced osteoporosis, Paget's disease of bone, and malignant hypercalcemia. They have been related to atypical femur fractures. We describe an 83-year-old woman on long-term bisphosphonates presenting with an atypical femur fracture. She underwent a surgical procedure and, a few months later, she presented with a nonunion of the periprosthetic femoral fracture. She underwent an additional surgical procedure and discontinued bisphosphonate treatment. As more atypical femur fractures associated with bisphosphonate use are being reported in the literature, the risk of an atypical femur fracture with bisphosphonate use should not be ignored.