Atypical Femoral Fracture Following Long-Term Bisphosphonate Therapy: An Uncommon Complication of a Common Treatment

We present a case of an 82-year-old woman with an atypical femoral fracture associated with prolonged bisphosphonate therapy. After a decade of ibandronate use for osteoporosis, she sustained a subtrochanteric femoral fracture following minimal trauma. Radiographic findings were consistent with atypical femoral fracture characteristics, and surgical management with intramedullary nailing was performed. Laboratory evaluation revealed no evidence of secondary bone disease. This case highlights the importance of monitoring patients on long-term bisphosphonates and considering drug holidays to minimize the risk of atypical fractures.