Effects of bilateral distal femoral stress in a patient on long-term pamidronate.

Recent studies have shown an association between long-term bisphosphonate therapy and low-energy subtrochanteric femoral fractures. These fractures have the unusual characteristics of occurring after a period of prodromal symptoms such as local pain, stress reaction, and low-energy transverse or oblique fractures in the subtrochanteric area of the femur. In this article, we present the case of a 62-year-old patient who was on pamidronate when she fell and sustained a femoral fracture resulting from bilateral stress phenomena in the distal third of the femoral shaft.