SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2015
Ulnar fractures with bisphosphonate therapy: a systematic review of published case reports.
Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Atypical fractures at non-classical sites associated with anti-resorptive therapy: a systematic review.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Pooled it
- Article
- Vascularized Medial Femoral Condyle Bone Grafting as a Salvage Strategy for Recalcitrant Atypical Ulnar Shaft Nonunion After Long-Term Bisphosphonate Therapy.Journal of hand surgery global online · 2026Article
- Staging classification of atypical ulnar fractures.Archives of osteoporosis · 2025Article
- Article
- Pexmetinib suppresses osteoclast formation and breast cancer induced osteolysis via P38/STAT3 signal pathway.Journal of bone oncology · 2022Article
- Radiological Reversibility of Incomplete Atypical Femoral Fracture with Cessation of Bisphosphonate: Including an Early Stage of Incomplete Fracture.Indian journal of orthopaedics · 2022Article
- Contemporaneous Insufficiency Fractures of Bilateral Femoral Necks in an Older Patient Taking Bisphosphonate: A Case Report and Literature Review.Case reports in orthopedics · 2022Article
- Exploring the Mechanisms Underlying Drug-Induced Fractures Using the Japanese Adverse Drug Event Reporting Database.Pharmaceuticals (Basel, Switzerland) · 2021Article
- Revision osteosynthesis after primary treatment of atypical ulnar fractures associated with bisphosphonate usage - Nonunion after ordinary open reduction and internal fixation.Archives of orthopaedic and trauma surgery · 2021Article
- Revision osteosynthesis after primary treatment of atypical ulnar fractures associated with bisphosphonate usage - Nonunion after ordinary open reduction and internal fixation.Archives of orthopaedic and trauma surgery · 2021Article
- Current concept of stress fractures with an additional category of atypical fractures: a perspective review with representative images.Therapeutic advances in endocrinology and metabolism · 2021Review
- Case Report: Prophylactic Plate Fixation for Incomplete Atypical Ulnar Fractures Resulting From the Use of Denosumab for Bone Metastases.Frontiers in endocrinology · 2021Article
- Bilateral atypical ulnar fractures occurring after long-term treatment with bisphosphonate for 7 years and with teriparatide for 2 years: a case report.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Treatment of Atypical Fracture of the Ulnar Diaphysis by Open Reduction and Internal Fixation with Teriparatide.Case reports in orthopedics · 2019Article
- Atypical Fracture of the Proximal Shaft of the Ulna Associated with Prolonged Bisphosphonate Therapy.Clinics in orthopedic surgery · 2018Article
- Treatment of Atypical Ulnar Fractures Associated with Long-Term Bisphosphonate Therapy for Osteoporosis: Autogenous Bone Graft with Internal Fixation.Case reports in orthopedics · 2017Article
- Bilateral distal fibula fractures in a woman on long-term bisphosphonate therapy.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016Article
- Effect of Long-Term Use of Bisphosphonates on Forearm Bone: Atypical Ulna Fractures in Elderly Woman with Osteoporosis.Case reports in orthopedics · 2016Article
- Mechanical competence of ovariectomy-induced compromised bone after single or combined treatment with high-frequency loading and bisphosphonates.Scientific reports · 2015Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
summaryA systematic review of eight ulnar fractures in seven patients with bisphosphonate therapy was performed to describe the characteristics and predisposing factors. The proximal ulna is likely to be fractured, especially in the dominant limb of elderly female patients using walking aids after 7 to 15 years of bisphosphonate use.
introductionLong-term bisphosphonate use has been suggested to result in decreased bone remodelling and increased risk of atypical fractures. While the relationship between bisphosphonate use and atypical femoral fractures has been extensively studied, there is relative rarity and unawareness of these fractures in the forearm. We conducted a systematic review of existing case reports to better describe the characteristics and predisposing factors for fractures occurring in patients with bisphosphonate therapy.
methodsThe systematic review was conducted according to PRISMA guidelines. All studies with ulnar fractures in individuals with history of bisphosphonate use were included, with data extracted and analysed in totality.
resultsSeven patients with eight fractures are included. Predisposing factors include elderly females requiring walking aids. There is a propensity for the proximal ulna to be fractured, especially in the dominant limb used for ambulation or transfer. All patients were on bisphosphonate for 7 to 15 years. All fractures were atraumatic, non-comminuted, transverse in configuration, had localised periosteal or endosteal thickening at the fracture site and generalised cortical thickening of the diaphysis.
conclusionUlnar fractures in patients with bisphosphonate therapy demonstrate features similar to those described for atypical femoral fractures, suggesting that these fractures could also possibly be due to bisphosphonate use. However, the ulna appears to be able to tolerate longer periods of alendronate use prior to fracture development. The mechanism and characteristics of these fractures additionally suggest the presence of repetitive stress that accumulates over time due to suppressed bone remodelling in patients on bisphosphonates, eventually resulting in these fractures.
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