# Atypical Femoral Fracture Following Long-Term Bisphosphonate Therapy: An Uncommon Complication of a Common Treatment

## TL;DR

An 82-year-old woman developed a rare type of femoral fracture after long-term use of bisphosphonates for osteoporosis, emphasizing the need for monitoring and possible drug breaks.

## Contribution

This case highlights the risk of atypical femoral fractures with long-term bisphosphonate therapy and suggests the importance of drug holidays.

## Key findings

- The patient had a subtrochanteric femoral fracture following minimal trauma after 10 years of ibandronate use.
- Radiographic findings were consistent with atypical femoral fracture characteristics.
- No evidence of secondary bone disease was found in laboratory evaluations.

## Abstract

We present a case of an 82-year-old woman with an atypical femoral fracture associated with prolonged bisphosphonate therapy. After a decade of ibandronate use for osteoporosis, she sustained a subtrochanteric femoral fracture following minimal trauma. Radiographic findings were consistent with atypical femoral fracture characteristics, and surgical management with intramedullary nailing was performed. Laboratory evaluation revealed no evidence of secondary bone disease. This case highlights the importance of monitoring patients on long-term bisphosphonates and considering drug holidays to minimize the risk of atypical fractures.