Bilateral atypical femoral shaft fractures and bisphosphonat
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There have recently been an increasing number of reports of atypical femoral fractures (AFFs) in patients on long term bisphosphonate (BP) therapy. BPs are potent inhibitors of osteoclast-mediated bone resorption and are widely recommended agents for the treatment of osteoporosis.However, the reported link between long term use of BPs and AFFs led to the appointment of a task force of the American Society for Bone and Mineral Research to address key questions related to this. They defined major and minor features for AFFs, where all major features must be present to define the femoral fracture as atypical. AFF, associated wth BPs, are typically described in the subtrochanteric region of the femur and are usually unilateral on presentation. We present a case of bilateral atypical femoral fractures occurring in the shafts of the femori secondary to long term ibandronic acid therapy.

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