THIGH PAIN MIGHT BE A PRODROMAL SYMPTOM OF ATYPICAL FRACTURE IN LONG TERM BISPHOSPHONATE USERS

Abstract

Introduction: Osteoporosis causes bones to lose their resilience, increases fragility and results in bone fracture even with minimal trauma during daily activities. We aimed to examine the patients who were treated for atypical fractures in terms of long-term bisphosphonate usage for the treatment of osteoporosis. Materials and Method: A retrospective study was conducted on 21 patients who underwent surgery for an atypical femur fracture between years 2007-2013. Demographic data, history of bisphosphonate treatment, trauma type, patient complaints prior to fracture, fracture type and the type of treatment used for the fracture were assessed. Results: The number of cases with atypical fractures was 21 and all of them had history of prolonged bisphosphonate use. The number of female patients was 19, and 2 patients were male, with an average age of 76.4 years. The number of patients with diaphyseal femur fractures was 17 and 4 patients had subtrochanteric femur fractures. Among the patients that have been using a bisphosphonate, alendronate (70 mg) was the most frequently used medication. The average length of bisphosphonate usage was 8.1 years and the average length of time that elapsed until a fracture occurred subsequent to the start of drug usage was 7.2 years. Prior to fracture, all of the patients had complaints of thigh pain that lasted on average for 8.5 months. Conclusion: Bisphosphonates are one of the widely used agents used in the treatment of osteoporosis. Thigh pain in patients with prolonged bisphosphonate usage should alarm the physicians for possible atypical fracture in the future.