• 1
    Odvina CV, Zerwekh ZE, Rao DS, Maalouf N, Gottschalk FA, Pak CY. Severely suppressed bone turnover: a potential complication of alendronate therapy. J Clin Endocrinol Metab. 2005; 90: 1291301.
  • 2
    Goh SK, Yang KY, Koh JSB, Wong MK, Chua SY, Chua DT, Howe TS. Subtrochanteric insufficiency fractures in patients on alendronate therapy. J Bone Joint Surg Br. 2007; 89: 34953.
  • 3
    Imai K, Yamamoto S, Anamizu Y, Horiuchi T. Pelvic insufficiency fracture associated with severe suppression of bone turnover by alendronate therapy. J Bone Miner Metab. 2007; 25: 3336.
  • 4
    Cheung RK, Leung KK, Lee KC, Chow TC. Sequential non-traumatic femoral shaft fractures in a patient on long-term alendronate. Hong Kong Med J. 2007; 13: 4859.
  • 5
    Armamento-Villareal R, Napoli N, Diemer KM. Prevalence of severe suppression of bone turnover among patients with atypical osteoporotic fractures. J Womens Health. 2007; 16: 1106.
  • 6
    Kwek EBK, Goh SK, Koh JSB, Png MA, Howe TS. An emerging pattern of subtrochanteric stress fractures: a long-term complication of alendronate therapy?. Injury. 2008; 39: 22431.
  • 7
    Lenart BA, Lorich DG, Lane JM. Atypical fractures of the femoral diaphysis in postmenopausal women taking alendronate. N Engl J Med. 2008; 358: 13046.
  • 8
    Visekruna M, Wilson D, McKiernan FE. Severely suppressed bone turnover and atypical skeletal fragility. J Clin Endocrinol Metab. 2008; 93: 294852.
  • 9
    Lenart BA, Nevasier AS, Lyman S, Chang CC, Edobor-Osula F, Steele B, van der Meulen MC, Lorich DG, Lane JM. Association of low-energy femoral shaft fractures with prolonged bisphosphonate use: a case control study. Osteoporos Int. 2009; 20: 135362.
  • 10
    Sayed-Noor AS, Sjödén GO. Subtrochanteric displaced insufficiency fracture after long-term alendronate therapy-a case report. Acta Orthop. 2008; 79: 5657.
  • 11
    Neviaser AS, Lane JM, Lenart BA, Edobor-Osula F, Lorich DG. Low-energy femoral shaft fractures associated with alendronate use. J Orthop Trauma. 2008; 22: 34650.
  • 12
    Shane E, Burr D, Ebeling PR, Abrahamsen B, Adler RA, Brown TD, Cheung AM, Cosman F, Curtis JR, Dell R, Dempster D, Einhorn TA, Genant HK, Geusens P, Klaushofer K, Koval K, Lane JM, McKiernan F, McKinney R, Ng A, Nieves J, O'Keefe R, Papapoulos S, Sen HT, van der Meulen MC, Weinstein RS, Whyte M. Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2010; 25: 226794.
  • 13
    Rizzoli R, Akesson K, Bouxsein M, Kanis JA, Napoli N, Papapoulos S, Reginster JY, Cooper C. Subtrochanteric fractures after long-term treatment with bisphosphonates: a European Society on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, and International Osteoporosis Foundation Working Group Report. Osteoporos Int. 2011; 22: 37390.
  • 14
    Odvina CV, Levy S, Rao S, Zerwekh JE, Rao DS. Unusual mid-shaft fractures during long-term bisphosphonate therapy. Clin Endocrinol (Oxf). 2010; 72: 1618.
  • 15
    Breglia MD, Carter JD. Atypical insufficiency fracture of the tibia associated with long-term bisphosphonate therapy. J Clin Rheumatol. 2010; 16: 768.
  • 16
    AO Foundation. Müller AO Classification of Fractures—Long Bones [Internet]. Davos, Switzerland: Arbeitsgemeinschaft für Osteosynthesefragen (AO) Foundation; 2010 [cited 2012 Mar 6]. Available from
  • 17
    Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, Prokuski L, Sirkin MS, Ziran B, Henley B, Audigé L. Fracture and dislocation classification compendium—2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007; 21: S1133.
  • 18
    Tytherleigh-Strong G, Walls N, McQueen MM. The epidemiology of humeral shaft fractures. J Bone Joint Surg Br. 1998; 80: 24953.
  • 19
    Giusti A, Hamdy NA, Dekkers OM, Ramautar SR, Dijkstra S, Papapoulos SE. Atypical fractures and bisphosphonate therapy: a cohort study of patients with femoral fracture with radiographic adjudication of fracture site and features. Bone. 2011; 48: 96671.
  • 20
    Tingart MJ, Apreleva M, von Stechow D, Zurakowski D, Warner JJ. The cortical thickness of the proximal humeral diaphysis predicts bone mineral density of the proximal humerus. J Bone Joint Surg Br. 2003; 85: 6117.
  • 21
    Jackson A, Scarffe JH. Upper humeral cortical thickness as an indicator of osteopenia: diagnostic significance in solitary myeloma of bone. Skeletal Radiol. 1991; 20: 3637.
  • 22
    Glüer CC, Cummings SR, Pressman A, Li J, Glüer K, Faulkner KG, Grampp S, Genant HK. Prediction of hip fractures from pelvic 429 radiographs: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res. 1994; 9: 6717.
  • 23
    Corrales LA, Morshed S, Bhandari M, Miclau T. Variability in the assessment of fracture healing in orthopaedic trauma studies. J Bone Joint Surg Am. 2008; 90: 18628.
  • 24
    Solomon DH, Hochberg MC, Mogun H, Schneeweiss S. The relation between bisphosphonate use and non-union of fractures of the humerus in older adults. Osteoporos Int. 2009; 20: 89501.
  • 25
    Knowelden J, Buhr AJ, Dunbar O. Incidence of fractures in persons over 35 years of age. A report to the M.R.C. Working Party on fractures in the elderly. Br J Prev Soc Med. 1964; 18: 13041.
  • 26
    Rose SH, Melton LJ 3rd, Morrey BF, Ilstrup DM, Riggs BL. Epidemiologic features of humeral fractures. Clin Orthop Relat Res. 1982; 168: 2430.
  • 27
    Bloom RA, Laws JW. Humeral cortical thickness as an index of osteoporosis in women. Br J Radiol. 1970; 43: 5227.
  • 28
    Bell KL, Loveridge N, Power J, Garrahan N, Stanton M, Lunt M, Meggitt BF, Reeve J. Structure of the femoral neck in hip fracture: cortical bone loss in the inferoanterior to superoposterior axis. J Bone Miner Res. 1999; 14: 1119.
  • 29
    Bell KL, Loveridge N, Power J, Garrahan N, Meggitt BF, Reeve J. Regional differences in cortical porosity in the fractured femoral neck. Bone. 1999; 24: 5764.
  • 30
    Chen H, Zhou X, Shoumura S, Emura S, Bunai Y. Age- and gender-dependent changes in three-dimensional microstructure of cortical and trabecular bone at the human femoral neck. Osteoporos Int. 2010; 21: 62736.
  • 31
    Schilcher J, Michaëlsson K, Aspenberg P. Bisphosphonate use and atypical fractures of the femoral shaft. N Engl J Med. 2011; 364: 172837.