Bisphosphonates are widely used for treatment of postmenopausal osteoporosis. Although short-term safety and efficacy of these
drugs have been investigated and documented, an increasing number of recent reports draw attention to the possible correlation
between long-term alendronate therapy and the occurrence of insufficiency fractures in the proximal femur owing to what is
known as severely suppressed bone turnover. We describe two femoral insufficiency fractures in two women receiving long-term
alendronate therapy. The first woman sustained a periprosthetic fracture at the tip of the femoral stem whereas the other
woman had a fracture in the subtrochanteric region. We analyze the characteristics and natural course of these two unique
fractures, and emphasize the importance of being aware of the possible correlation between long-term alendronate therapy and
insufficiency femoral fractures.
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