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    Bisphosphonate use and atypical fractures of the femoral shaft

    N Engl J Med. 2011 May 5;364(18):1728-37.

    The authors reviewed 1234 radiographs from women aged 55 years or older who had a subtrochanteric or shaft fracture of the femur in Sweden in 2008. Of these 59 were identified as “atypical”. The increase in the risk of atypical fractures for users of bisphosphonates was 5 cases (95% CI, 4 to 7) per 10,000 patient-years and risk increased with the duration of use (odds ratio of 1.3, 95% CI, 1.1 to 1.6) per 100 prescribed daily doses. After drug discontinuation, there was a 70% reduction in risk for every year since last use. The authors conclude that the risk of atypical fractures associated with bisphosphonates in patients at high risk for osteoporotic fractures is small compared to the beneficial effects of the drugs.
    Authors: Schilcher J, Michaëlsson K, Aspenberg P

    N Engl J Med. 2011 May 5;364(18):1728-37

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