Atypical femur fractures: A case series study from a tertiary care hospital in urban India

• Author Details:   
• Arun Padmanandan
• Pushkar Chawla
• Ritabh Kumar ^*
• Mansi Sharma

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Anti-osteoporosis medications have led to a significant improvement in the quality of life of the elderly. Amongst them, bisphosphonate therapy has reported the most impressive outcomes in terms of reduction in the incidence of fractures. With increasing use of the drugs an association was reported from Asian countries with low energy femur fractures. The cause for a higher incidence of such low energy atypical femur fractures in Asian population could be due to genetic variances in bone remodelling and bisphosphonate metabolism, a higher incidence of osteomalacia (Vitamin D deficiency), or a tendency for increased femoral bowing resulting in accumulation of localized cortical stresses. From 2020 to 2023, we studied 19 cases of atypical femur fractures that presented to our trauma unit. Most of the patients had unilateral pathology. A diligent search for the pathology on the contralateral side was positive in only 3 of the 19 patients. Five patients did not report the use of bisphosphonates. Spontaneous onset of some unease or discomfort in the thigh in the elderly females must not be ignored. Intramedullary femoral nail seems to be the most effective treatment strategy. Prophylactic nailing must be recommended to avoid progression to complete fracture.

Keywords: Atypical femur fractures, Bisphosphonates, Prophylactic femur nailing.