Evolution of Atypical Femur Fractures and the Association with Bisphosphonates

For almost 15 years bisphosphonates have been the mainstay of prevention and treatment of fragility fractures, particularly in post-menopausal women. As a result, there has been a decrease in fragility fractures, along with the health care costs associated with treating them. However, with all drugs, there are always concerns with side effects and potential complications. Atypical femur fractures have been observed in women taking bisphosphonates, a complication the drug was designed to prevent. There is no definitive link between bisphosphonates and atypical femur fractures and no protocol to managing these fractures. This review discusses the evolution and development of bisphosphonates and offers the latest information regarding evidence surrounding the link to atypical femur fractures.