The Bilateral Insufficiency Fracture of Proximal Femur due to Bisphosphonate Overuse in the Nonosteoporotic Bone

62 year old female underwent closed reduction of subtrochanter fracture by the minor trauma. She was checked quantitative computerized tomography (QCT) for the bone mineral density. It showed highly elevated density above the normal range. She could easily take the bisphosphonate for 3 and half years without regular evaluation of the bone mineral density. The fracture was bilateral and atypical fracture pattern in the subtrochanter area. These kinds of fracture were occurred in the osteoporotic bones in the previous literature, so we hardly conclude the culprit of bisphosphonate related atypical fractures. The prevalence of these kinds of insufficiency fracture among the normal population and bisphosphonate medicated patients has been still debated but we can strongly suggest that our fractures were related to the bisphosphonate medication because she was a nonosteoporotic bone who took a bisphosphonate medication.