Insufficiency femoral fractures in patients undergoing prolonged alendronate therapy.

A 76-year-old woman complaining of pain and swelling in her right thigh was admitted to our clinic. She had been undergoing alendronate therapy for more than 10 years. Physical examination revealed a mild swelling, pathologic motion and pain in her right thigh. Radiograms showed a transverse fracture with a medial spike in the area of thickened cortices of femoral diaphysis. She received surgical stabilization. The patient is now pain-free and she has walked with full weight bearing without any complications since the first postoperative day. Dual-energy X-ray absorptiometry revealed a T-score for the lumbal spine of -2.89 and for the hip of -3.55. We stopped alendronate treatment. However the patient is receiving only calcium and vitamin D.