Atypical metatarsal fracture in a patient on long term bisphosphonate therapy

Abstract

A 24 years old female of cushing disease had undergone adrenelectomy. She was put on alendronate and steroid. After six and a half years she developed pathological fracture subtrochanteric femur. The patient was treated with proximal femoral nailing and the fracture united. 2 years later she developed pain right foot. She was diagnosed as transverse fracture of fifth metatarsal. We report this rare case of atypical metatarsal fracture in a patient on long term bisphosphonate therapy.

Association between Bone Mineral Density and Fracture Characteristics in the 5th Metatarsal Bone Base Fracture in Elderly for Prediction of Osteoporotic Fracture

“…However, this may be due to the small number of samples, so further studies with a larger sample are needed to verify a more accurate correlation. Also, a previous study by Pradhan et al [25] reported Zone 3 atypical fracture associated with long-term use of bisphosphonates and that long-term use of osteoporosis drugs can cause atypical metatarsal fractures, so it is necessary to take medical history closely. Also, in our study, Zone 3 metatarsal fracture was observed in patients with osteoporosis who took long-term bisphosphonate therapy.…”

A Typical Metatarsal Fracture in a Patient on Long-Term Bisphosphonate Therapy

“…It is believed that subtrochanteric stress fractures, pelvic insufficiency fractures, and femoral fractures are associated with the long-term consumption of bisphosphonate [12]. In this regard, metatarsal stress fractures have been observed, as well [13,14]. In 2005, Odvina et al identified a group of 9 patients who developed spontaneous non-spinal fractures while on the long-term consumption of alendronate.…”