Schneider Jennifer P
Tucson, AZ, USA.
Geriatrics. 2009 Jan;64(1):18-23.
Several recent medical articles have described multiple cases of unusual low-impact subtrochanteric stress fractures or completed fractures of the femur in patients who have been on the bisphosphonate alendronate for several years for osteoporosis or osteopenia. Some patients have experienced such fractures in both femurs. The fractures are often preceded by pain in the affected thigh, may have a typical x-ray appearance, and many have delayed healing. It has been hypothesized that in some patients, long-term alendronate causes oversuppression of bone turnover, resulting in bones that are brittle despite improved bone density. In patients with atypical or low-impact fractures of the femoral shaft, consider the possible connection with alendronate use. Some bone specialists now recommend stopping alendronate in most patients after 5 years.
最近的几篇医学文章描述了多例不寻常的低冲击力股骨转子下应力性骨折或股骨完全骨折的病例，这些患者因骨质疏松或骨质减少已服用双膦酸盐阿仑膦酸钠数年。一些患者双侧股骨都出现了此类骨折。骨折前通常患侧大腿会疼痛，X线表现可能典型，且许多骨折愈合延迟。据推测，在一些患者中，长期使用阿仑膦酸钠会导致骨转换过度抑制，尽管骨密度有所改善，但骨骼仍变脆。对于股骨干非典型或低冲击力骨折的患者，要考虑与使用阿仑膦酸钠的可能关联。一些骨专科医生现在建议大多数患者服用阿仑膦酸钠5年后停药。
