Atypical femoral fracture focused on relation of bisphosphonate use, frequently. However, the mechanism of atypical femoral fracture was not yet clarified. Atypical femoral fractures have been kept femoral shaft cortical thickness and BMD, practically. We hypothesized that atypical femoral fractures were associated with impaired bone quality and curvature of femoral shaft. We experienced four atypical femoral fractures. One was subtrochanteric and three were shaft fracture. Two cases received bisphosphonate therapy for 3–5 years. BMD, bone metabolic markers, and bone quality markers were evaluated. Histomorphometry and collagen cross-link analysis were performed. Curvature of femoral shaft and 3-D finite element analysis in one incomplete fracture case were assessed.Introduction
Materials & Methods
