Bisphosphonate-related bilateral femoral fractures

Case contributed by Dr Henry Knipe

Presentation

Thigh pain.

Patient Data

Age: 65 years
Gender: Female
X-ray

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. 

X-ray

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
Case created: 28th May 2017
Last edited: 22nd Jun 2017
Inclusion in quiz mode: Included

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