J Korean Fract Soc.  2017 Jul;30(3):137-141. 10.12671/jkfs.2017.30.3.137.

Atypical Fracture-Like Insufficiency Fracture of the Tibia with Prolonged Bisphosphonate Drug: A Case Report

• Park MJ
• Lee SJ
• Kam JH
• Lee YT
• Yoo JH
• Oh HC
• Ha JW
• Park Y
• Park SH
• Kim SH
• Yoon HK

• KMID: 2424122
• DOI: http://doi.org/10.12671/jkfs.2017.30.3.137

Abstract

Atypical femoral fracture related to a long-term bisphosphonate therapy has commonly been reported; however, a fracture at the site other than the femur has rarely been reported to date. Herein, we report a case of a patient on long-term bisphosphonate therapy who presented atypical tibial insufficiency fracture at the anterolateral aspect of diaphysis, without trauma. We, for the first time in Korea, present this case with a literature review.

Keyword

Tibial diaphysis; Atypical tibial insufficiency fracture; Bisphosphonate

MeSH Terms

Diaphyses
Femoral Fractures
Femur
Fractures, Stress*
Humans
Korea
Tibia*

Figure

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  Fig. 1 Preoperative radiograph shows atypical tibial diaphyseal fracture (white arrows), including periosteal reaction, endosteal thickening, and a radiolucent fracture line.

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  Fig. 2 Preoperative computed tomography shows periosteal reaction, cortical thickening, and transverse fracture line (white arrows).

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  Fig. 3 Bone scan of this patient shows increased uptake (arrow) at the anterolateral area of tibial diaphysis.

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  Fig. 4 Using intramedullary nailing, operation was performed.

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  Fig. 5 The radiographs of tibia taken eight months after the operation show callus formation at the fracture site, with a diminished gap of fracture.

Reference

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