Atypical Fractures of the Femur Related to Prolonged Treatment with Bisphosphonates for Osteoporosis

Background: Bisphosphonates reduce the overall risk of fractures among patients with osteoporosis, and this beneficial effect is long-lasting. However, since bisphosphonates inhibit bone remodeling, they may enhance the formation and propagation of micro-cracks over time and patients May therefore be prone to atypical fatigue fractures, mainly in the subtrochanteric region and femoral shaft. Objectives: To present two cases of subtrochanteric fractures related to bisphosphonate treatment, and review the current literature. Conclusions: Despite the overall beneficial effect of bisphosphonates, further research is required to prevent this significant complication.