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With the increase of osteoporosis in older adults, the diagnosis and treatment of abnormal hip fractures, such as bisphosphonate-related proximal femoral fractures, has become more important. According to Dr. Edward J. Fox, MD, obesity is often managed through the long-term use of bisphosphonate treatment, which can inhibit osteoclast-mediated bone regeneration. Over the prolonged utilization of bisphosphonate, patients may develop atypical proximal femoral fractures.
Understanding Atypical Femur Fractures
Atypical femur fractures are characterized as stress fractures which commonly occur in the proximal one-third of the diaphyseal bone, although they might also occur more distally, developing in the lateral cortex and slowly progressing medially. “With irregular fractures, a small ‘beak’ of bone can form on the lateral surface of the femur and that is where the fracture generally begins,” explains Dr. Fox. This contrasts with stress fractures which occur laterally in the medial portion of the bone.
As a result, when a patient with osteoporosis reports feeling hip and knee pain without previous damage or injury, healthcare professionals will ask about bisphosphonate treatment. It is essential for the doctor to request x-rays of the hip and femur shaft for proper diagnosis. It is also important to request x-rays of the opposite femur, as atypical bisphosphonate-related proximal femoral fractures frequently occur bilaterally. Dr. Edward J. Fox urges patients to discontinue bisphosphonate use in the case of hip fractures, followed by the subsequent use of crutches or a walker. Patients will eventually be able to resume regular physical activities.
Approximately more than 250,000 hip fractures occur in the United States, causing significant patient disability. The variety of hip fractures in older adults, including bisphosphonate-related proximal femoral fractures, often need several treatment approaches which depend on different considerations, such as the mechanism of injury, location and degree of the fracture, as well as the patient’s age and overall health and wellness. For more information, please feel free to ask Dr. Jimenez or contact us at (915) 850-0900.