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. 2012 Sep;9(3):166-9.
Epub 2012 Dec 20.

Healing of subtrochanteric atypical fractures after strontium ranelate treatment

Armando Luis Negri  1 , Francisco Rodolfo Spivacow
Affiliations

Healing of subtrochanteric atypical fractures after strontium ranelate treatment

Armando Luis Negri et al. Clin Cases Miner Bone Metab. 2012 Sep.

Abstract

Oral bisphosphonates comprise the most widely prescribed class of antiosteoporotic drugs. Recent reports, however, suggest a link between prolonged bisphosphonate use and atypical low-energy, subtrochanteric fractures. We describe the clinical course of two patient treated for a long term with different bisphosphonates who developed subtrochanteric atypical fractures. They were treated initially with intramedullary rodding without pain disappearance or healing of the fracture. Strontium ranelate, a new orally administered agent for the treatment of osteoporosis, was given to these patients with complete closure of the fracture and pain disappearance after a few months. We conclude that based on the chronology of fracture healing and pain disappearance of our patients and published evidence that strontium ranelate can accelerate fracture healing in a rat model, that strontium ranelate had a positive anabolic effect that contributed to fracture healing that produced the secondary disappearance of pain.

Keywords: atypical fractures; bisphosphonate; delayed healing; strontium ranelate.

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Figures

Figure 1
Figure 1
Case 1: Postoperative non-comminuted fracture of the femur diaphysis, before strontium ranelate treatment.
Figure 2
Figure 2
Case 1: After five months of strontium ranelate treatment.
Figure 3
Figure 3
Case 2: Postoperative oblique fracture of the femur diaphysis before strontium ranelate treatment.
Figure 4
Figure 4
Case 2: After five months of strontium ranelate treatment.
See this image and copyright information in PMC

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