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Case Reports
. 2014 May;21(2):155-9.
doi: 10.11005/jbm.2014.21.2.155. Epub 2014 May 31.

Atypical femoral fracture combined with osteonecrosis of jaw during osteoporosis treatment with bisphosphonate

Yougun Won  1 , Joon-Ryul Lim  2 , Young-Hwan Kim  2 , Hyung-Keun Song  3 , Kyu Hyun Yang  2
Affiliations
Case Reports

Atypical femoral fracture combined with osteonecrosis of jaw during osteoporosis treatment with bisphosphonate

Yougun Won et al. J Bone Metab. 2014 May.

Abstract

Bisphosphonate, a potent anti-resorptive agent, is generally accepted as a safe, effective, well tolerated treatment for postmenopausal osteoporosis. Atypical femoral fracture (AFF) and bisphosphonate related osteonecrosis of jaw (BRONJ) are the increasing morbidities in patients treated with long term bisphosphonate. Pathogenic mechanisms of AFF and BRONJ are not fully identified and not identical. We report a case of BRONJ followed by AFF and its nonunion in a 67-year-old woman patient receiving an oral bisphosphonate during 7 years for the treatment of osteoporosis.

Keywords: Atypical femoral fracture; Bisphosphonate.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
(A) Preoperative radiograph shows subtrochanteric fracture of left femur: Transverse fracture with medial beak were noticed. (B) Postoperative radiograph after the initial operation.
Fig. 2
Fig. 2
Nonunion and hardware failure developed at seven months after the operation.
Fig. 3
Fig. 3
One year after hardware exchange and auto iliac bone graft for nonunion and hardware breakage. Lateral cortex osteotomy was performed at lateral cortex for sliding (arrow).
Fig. 4
Fig. 4
(A) The dental panoramic view demonstrates osseous sclerosis (arrow) and radiolucent lesion with irregular margin on the mandible. (B) Clinical photo of extracted socket with ulceration. (C) The dental panoramic view after sequestrectomy.
See this image and copyright information in PMC

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