![]() Although a clear causal link between bisphosphonates and such atypical femur fractures has not been established, the widespread use of these otherwise effective agents has come under scrutiny amidst increasing public and medical concerns of this potential complication. ![]() ![]() Such ‘atypical’ features include a history of prodromal thigh pain, the development of circumferential cortical thickening and cortical stress lesions that may precede a complete transverse or oblique fracture of the subtrochanteric femur. Similar fractures were later described by Lenart and colleagues as ‘atypical’ in that they involved the strongest part of the femur, namely the subtrochanteric and diaphyseal region, and were characterized by features distinctly different from ‘typical’ osteoporotic femur fractures. However, since 2005, there have been increasing concerns regarding the potential risk of an unusual type of femur fracture amongst patients on bisphosphonate therapy. Bisphosphonates are also generally well tolerated and considered to have an excellent safety profile even at higher doses. A recent study estimated that between 20, 144,670 low-energy fractures were prevented amongst women who took bisphosphonates in the United States. Numerous large clinical trials have demonstrated their efficacy in reducing bone turnover, increasing bone mineral density and reducing vertebral and non-vertebral fracture risk in patients with osteoporosis. ![]() Bisphosphonates are highly effective in the treatment of osteoporosis. ![]()
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