View Entire Collection
By Clinical Topic
By State Requirement
Diabetes – Summer 2012
Future of Nursing Initiative
Heart Failure - Fall 2011
Influenza - Winter 2011
Nursing Ethics - Fall 2011
Trauma - Fall 2010
Traumatic Brain Injury - Fall 2010
Fluids & Electrolytes
In a letter to The New England Journal of Medicine, researchers reported on a small study of 15 postmenopausal women who experienced atypical low-energy fractures of the femur. The women had been taking alendronate (Fosamax) for a mean period of about 5 years to treat osteoporosis. Alendronate and other bisphosphonates are commonly prescribed for postmenopausal women with osteoporosis to increase bone mass and prevent fractures. Low-energy fractures are defined as occurring in a fall from standing height or less.
All 15 patients experienced subtrochanteric or proximal diaphyseal fractures. Statistically, fractures of the subtrochanteric or diaphyseal regions are "relatively rare" in postmenopausal women, the researchers noted.
Fractures in 10 of the patients had an unusual radiographic pattern. On average, these 10 patients had been using alendronate for about 7 years, significantly longer than the 5 patients without this pattern (about 3 years). No information was available about the status of the patients with regard to metabolic bone disease.
The researchers said their results provide more evidence of a possible link between prolonged bisphosphonate use and low-energy femur fractures. One theory for the link is that by suppressing bone turnover, bisphosphonates allow microdamage to accumulate in bone.
Because some patients may be especially vulnerable to the negative effects of long-term suppression of bone turnover, the researchers called for a prospective study to investigate the risks and identify susceptible patients.
Source: Lenart BA, et al., Atypical fractures of the femoral diaphysis in postmenopausal women taking alendronate, The New England Journal of Medicine, March 20, 2008.
Sign up for our free enewsletters to stay up-to-date in your area of practice - or take a look at an archive of prior issues
Join our CESaver program to earn up to 100 contact hours for only $34.95
Explore a world of online resources
Back to Top