Atypical fractures at non-classical sites associated with anti-resorptive therapy: a systematic review
An erratum to this article was published (J Bone Miner Res, 9 Oct 2026 ↗)
Authors' conclusion
Atypical fractures are rare and should not deter physicians from appropriate anti-resorptive therapy for osteoporosis. However, clinicians should be alert to their presence at additional sites to the femur.
Study context
- Population
- Adults (aged >18 yr) receiving anti-resorptive medication for >3 yr with atypical fractures at sites outside the American Society for Bone and Mineral Research (ASBMR) atypical femur fractures (AFF) case definition66 articles · 151 cases
- Participants
- 114 adults
- Outcome
- Characteristics of atypical fractures at non-classical sites
Methodological detailstwo independent reviewers, Search of PubMed, Medline (Ovid), Embase (Ovid), Cochrane, Web of Sciences and conference abstracts; English full-text articles
- Two independent reviewers
- Search of PubMed, Medline (Ovid), Embase (Ovid), Cochrane, Web of Sciences and conference abstracts; English full-text articles
Pooled result
As reported in the abstract
- Alendronate monotherapy
- 44%
- Transverse fractures
- 95%
- Minimal or no trauma
- 96%
- Non-comminuted
- 98%
- Cortical thickening of surrounding bone
- 69%
- Anti-resorptive treatment ceased after atypical fracture
- 89%
Original publication
Atypical fractures at non-classical sites associated with anti-resorptive therapy: a systematic review. J Bone Miner Res. Published 30 September 2024. doi:10.
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