Atypical Fracture of the Proximal Shaft of the Ulna Associated with Prolonged Bisphosphonate Therapy

Abstract

Atypical fractures have been reported as a complication of long-standing bisphosphonate therapy and occur commonly in the subtrochanteric region or shaft of the femur showing typical radiographic features. We encountered a case of atypical fracture of the proximal one-third of the shaft of the ulna. Radiographic findings of this case differed from previously reported cases of ulnar fracture in terms of showing a transverse fracture line with cortical thickening and an oblique fracture line with anterior cortical spike. On the other hand, these findings were similar to radiographic features of atypical femoral fractures. The present case was managed surgically and union of fracture was achieved after 6 months. As there are possibilities of occurrence of atypical fractures in sites other than the femur, the physicians should cautiously examine the patients' history and radiographic findings.

Resveratrol can enhance osteogenic differentiation and mitochondrial biogenesis from human periosteum-derived mesenchymal stem cells

“…However, these medications can cause complications when used for a long time. In particular, bisphosphonate has complications such as gastrointestinal irritation, atypical fracture due to decreased bone replacement rate, and osteonecrosis of the jaw bone [49][50][51][52]. In addition, venous thromboembolism can occur as a complication when using SERMs [53,54].…”

Resveratrol can enhance osteogenic differentiation and mitochondrial biogenesis from human periosteum-derived mesenchymal stem cells

“…However, these medications can cause complications when used for a long time. In particular, bisphosphonate has complications such as gastrointestinal irritation, atypical fracture due to decreased bone replacement rate, and osteonecrosis of jaw bone (49)(50)(51)(52). In addition, venous thromboembolism can occur as a complication when using SERMs (53,54).…”

Treatment of Atypical Fracture of the Ulnar Diaphysis by Open Reduction and Internal Fixation with Teriparatide

“…Four patients have been treated conservatively [4, 6, 10, 13], and four others had fractures fixed with a plate and a bone graft [5, 7, 12]. Four of five fractures treated by internal rigid fixation [3, 8, 9, 11] united uneventfully, and complications developed in one patient during the healing process.…”