Neviaser AS, Lane JM, Lenart BA, et al. Low-energy femoral shaft fractures associated with alendronate use. J Orthop Trauma. 2008 May-Jun;22(5):346-350.
http://www.jorthotrauma.com/pt/re/jorthotrauma/fulltext.00005131-200805000-00011.htm
http://www.jorthotrauma.com/pt/re/jorthotrauma/pdfhandler.00005131-200805000-00011.pdf
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J Orthop Trauma. 2008 May-Jun;22(5):346-50.
Low-energy femoral shaft fractures associated with alendronate use.
Neviaser AS, Lane JM, Lenart BA, Edobor-Osula F, Lorich DG.
Hospital for Special Surgery, New York, NY, USA.
OBJECTIVE: Increasing evidence suggests long-term alendronate use may overly suppress bone metabolism, limiting repair of microdamage and creating risk for insufficiency fractures. The purpose of this study is to demonstrate an association between alendronate use and a specific pattern of low-energy femoral shaft fracture. DESIGN, SETTING, AND PATIENTS: A retrospective review was performed of patients with femoral shaft fractures admitted to a Level 1 trauma center between January 2002 and March 2007. Seventy low-energy fractures were identified. MAIN OUTCOME MEASURE: The medical records were reviewed, and the incidence and duration of alendronate use were recorded. The incidence of a specific femoral shaft fracture in those patients taking alendronate compared with those not being treated was determined. RESULTS: There were 59 females and 11 males. The average age was 74.7 years. Twenty-five (36%) were being treated with alendronate. None of the patients had used or were using other bisphosphonates. Nineteen (76%) of these 25 patients demonstrated a simple, transverse fracture with a unicortical beak in an area of cortical hypertrophy. This fracture pattern was seen in only 1 patient (2%) not being treated with alendronate. Alendronate use was a significant risk factor for the fracture pattern (odds ratio [OR]) 139.33, 95% CI [19.0-939.4], P
PMID: 18448990
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see also:
New York Times: Drugs to Build Bones May Weaken Them
http://www.nytimes.com/2008/07/15/health/15well.html