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KMID : 1216720110030010008
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Korean Journal of Gynecologic Endocrinology
2011 Volume.3 No. 1 p.8 ~ p.16
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Atypical Subtrochanteric and Diaphyseal Femoral Fractures in the Management with Bisphosphonates
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Song Jae-Yen
Kwak Se-Hyoun
Park Tae-Chul
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Abstract
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Although the use of bisphosphonates reduces the risk of vertebral, non-vertebral fracture effectively, some concerns
were raised about atypical fracture due to severely suppressed bone turnover. These fractures have shown radiologic
features of transverse or short oblique fracture, non-comminuted fracture, cortical hypertrophy, stress fracture and
periosteal reactions of symptom affected side and/or opposite side, and delayed healing along with clinical symptoms
of prodromal symptoms or bilaterality. Bone biopsy shows signs of decreased rate of bone formation, and
sometimes shows increased rate of bone resorption. Bone turnover markers are generally normal or slight increased.
Although, atypical fracture’s prevalence rate and correlation with bisphosphonates are still uncertain, the rate increases
among patient who took bisphosphonates for more than 3 years. But incidence of theses fractures are very
rare and use of bisphosphonates brings out much more benefit than side effect, the use of bisphosphonates is recommended under careful evaluation for atypical fracture. And furthermore studies were required.
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KEYWORD
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Bisphosphonates, Bone, Fracture
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