Abstract

OLIVEIRA, João Pedro; CRUZ-FERREIRA, António  and  FAISCA, Jorge. Fratura espontânea bilateral do fémur e ingestão crónica de bifosfonatos. Rev. Port. Ortop. Traum. [online]. 2013, vol.21, n.4, pp.535-541. ISSN 1646-2122.

Bisphosphonates are considered a first-line therapy on the treatment and prevention of postmenopausal osteoporosis, increasing bone mineral density and reducing the risk of fracture. Its effectiveness has been widely confirmed by several studies however there have been reports in the literature suggesting a possible association between the use of bisphosphonates and an increased risk of non-osteoporotic fractures. We report a case of a 66-years old woman with history of osteoporosis, confirmed by bone mineral density, without major risk factors, treated continuously for the last 13-years with bisphosphonates supplemented by oral calcium, who suffered a bilateral femur fracture after low-energy trauma. Both fractures, separated temporally for 1-year, were surgically treated and on the complementary study made we weren’t able to detect any alteration on calcium metabolism, osteoporosis or neoplastic disease. This case fulfils the criteria for atypical femur fracture exalting the possibility of the side effects after chronic use of bisphosphonates. If in one hand scientific evidence has not yet been unequivocally established, on the other hand the efficacy of these drugs on the prevention of osteoporotic fractures is widely supported by randomised clinical studies. With this case we expect to contribute for the growing discussion about a possible link between the chronic therapy with bisphosphonates and their impact on bone turnover.

Keywords : Pathological fracture; bisphosphonates; low energy trauma; osteoporosis.

        · abstract in Portuguese     · text in Portuguese     · Portuguese ( pdf )