Bilateral Femoral Insufficiency Fractures Likely Related to Long-Term Alendronate Therapy英文文献资料.docVIP

SAGE-HindawiAccesstoResearch JournalofOsteoporosis Volume2011,ArticleID810697,4pages doi:10.4061/2011/810697 CaseReport BilateralFemoralInsuf?ciencyFracturesLikelyRelatedto Long-TermAlendronateTherapy RavindraGudena,JasonWerle,andKellyJohnston DepartmentofOrthopedics,UniversityofCalgary,711B,3607-49STNW,Calgary,Alberta,CanadaT3A2H3 CorrespondenceshouldbeaddressedtoRavindraGudena,gudenar@ Received4November2010;Accepted8March2011 AcademicEditor:DavidL.Kendler Copyright?2011RavindraGudenaetal. This is an open access article distributed under the Creative CommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Osteoporosis-relatedfracturesareamajorpublichealthproblemandoneintwowomenandoneinfourmenarea?ectedwith osteoporosis-relatedfractures.Alendronate(Fosamax)isoneofthe?rstbisphosphonatesusedtotreatosteoporosise?ectively. Recently,however,thereisaconcernregardinglongboneinsu?ciencyfracturesrelatedtolong-termalendronatetherapy.We reportacaseofbilateralfemoralinsu?ciencyfractures likelyrelatedtolong-termalendronatetherapy, theclassicsymptoms, signs,andtreatmentofthesefractures. 1.Introduction with lumpectomy 10 years ago and has a history of well- controlled asthma, forwhich she did not require corticos- teroidtreatment.Shehadbeenreceivingalendronatetherapy forpostmenopausalosteoporosisfor10years.Radiographs revealed lateral cortical thickeningof the mid-diaphysis of both femurs (Figure 1). The patient underwent a bone scan to rule out the possibility of metastases due to her previoushistory.Thebonescanraisedthepossiblediagnosis of a healing stress fracture. Computed tomography scan con?rmed a stress fracture (Figure 2). She was given the advice of protective weight bearing and planned followup. Four days after consultation, she tripped and sustained a transverse fracture of the left femur and underwent uneventful femoral intramedullary nailing (Figures 3(a) and3(b)).Anendocrinologyc