Atypical peri-prosthetic fracture due to longterm use of bisphosphonates)

 

 Young patient post renal transplant on long term use of oral bisphosphonates post bilateral staged THR at 2 year intervals. 

Classic features of a atypical femoral fracture on the right side and an impending fracture on the left. Medical management of the atypical fracture is still unclear.

                                       

6cm distal fixing wagner stem was used with an ETO.

                                      

                                     

Metabolic workup: