Bisphosphonate-related bilateral femoral fractures

Case contributed by Dr Henry Knipe


Thigh pain.

Patient Data

Age: 65 years
Gender: Female

Pelvis and right femur

Complete fracture of the mid proximal femoral shaft with a transverse orientation of the fracture line medial "beaking". Distal rotation and displacement. 


Left femur

Cortical thickening of the anterolateral aspect of the proximal mid femoral shaft. 

Case Discussion

This patient had a history of long-term bisphosphonate use, and these are the typical fracture patterns. In patients with a fracture pattern suspicious for being secondary to bisphosphonate use, imaging of the contralateral femur is recommended as it can show an early/incomplete insufficiency fracture such as in this case. These are at higher risk of complete fracture, and are sometimes prophylactically treated with an IM nail. 

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Case information

rID: 53641
Published: 16th Jun 2017
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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