Uniqueness of a Fosamax Fracture

Individuals who take bisphosphonate medications, such as Fosamax still have a risk of a fracture… A Fosamax fracture.

English: Fracture across waist of scaphoid bon...

Fracture across waist of scaphoid bone (indicated by arrow). (Photo credit: Wikipedia)

Recently, the medical community has been discussing the uniqueness of bone fracture with individuals who take bisphosphonate medications for osteoporosis. These observations have brought some to the conclusion that the mechanisms of bisphosphonate drugs create a “false” promise of greater bone density. Meaning, these medications make someone appear to have stronger bones in a DXA scan, however underneath the layer of bone that shows well in the scan lies a deficient structure.

Dr. Joseph M. Lane has spent over 30 years of looking at fracture x-rays. He explains that the neck of the femur (thigh bone) will always fracture first. Fractures in individuals who take bisphosphonate medications, still fracture at a significant rate, seemingly defeating the purpose of the medication, also the fractures differ from those of un-medicated individuals.

Seventy patients who had experienced a “low-energy” femur fracture were examined in a recent study. A low-energy fracture is defined as a fracture that occurs when an individual falls from standing height or less. Tripping and breaking a femur on impact is an example of a low-energy femur fracture. Out of the 70 patients, 25 had been taking Fosamax for more than four years. The Fosamax fracture patients all had similar fracture characteristics, while all seemed to have proper non-osteoporotic bone density. The question remains if this “false” bone density that bisphosphonate drugs provide protects at all, or is potentially making bones more brittle. More research is needed to determine if this is the case.


Neviaser, A. Lane, J., Lenart, B. Edobor-Osula, F. and Lorich, D. (2008). Low-Energy Femoral Shaft Fractures Associated With Alendronate Use. Journal of Orthapedic Trauma. 2008;22:346–350


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