Atypical Femur Fractures in Post-Menopausal Patients Taking Bisphosphonates and Their Indication When to Start after Holiday Period of 5 Years and Its Effects

Postmenopausal women are at risk of fractures owing to osteoporosis, which is worsened by low oestrogen. Bisphosphonates like ibandronate, zoledronic acid, alendronate, and risedronate limit bone resorption and increase bone density, reducing fracture risk. Although atypical femur fractures (AFFs) are uncommon, they are associated with dangerous complications of long-term bisphosphonate therapy. Early fracture identification before they occur is crucial to minimizing complications. The review examines bisphosphonate-related medical issues in postmenopausal women with atypical femur fractures. The study also addressed whether to resume bisphosphonate medication following a pharmacological holiday, which reduces fracture risk. A thorough literature search was undertaken using PubMed, Embase, and the Cochrane Library. The search criteria included atypical femur fractures, bisphosphonates, osteoporosis, and therapy duration. Following screening, studies fulfilling inclusion criteria were assessed utilizing the Cochrane Risk of Bias Tool and Newcastle-Ottawa Scale. Several studies examined the association between long-term bisphosphonate usage and atypical femur fractures. Bisphosphonates reduce osteoporotic fractures but may raise AFF risk over time. The studies also emphasize the significance of individualized bisphosphonate treatment programs and thorough monitoring, especially after a medication holiday. Bisphosphonates reduce fracture risk, although atypical femur fractures require cautious treatment duration and timing, especially following a medication holiday. Selection bias and confounding variables may have limited the evidence of this research. The research design and use of real-world data may also affect its validity and reliability. To enhance treatment recommendations and patient outcomes, longitudinal research on bisphosphonates’ long-term impact on bone health and fracture risk is needed.