Clinical calcium
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Recent studies indicating a relationship between duration of bisphosphonate therapy and risk of atypical femoral fractures, together with epidemiological data demonstrating divergent trends in hip versus subtrochanteric fracture incidence, support the contention that there is an association between bisphosphonate therapy and atypical femoral fractures. However, although there are biologically plausible mechanisms by which bisphosphonates may impair bone strength, a direct causal association has yet to be established. ⋯ Identification of the factors that predispose individuals to develop these rare fractures may hold the key to uncovering their pathophysiology. The benefits of bisphosphonates use outweigh the risks.