569 - Atypical femur Fracture in a Male Without History of Bisphosphonate Use: A Case Report

Case Diagnosis: Atypical femur fractures are uncommon, particularly in bisphosphonate-naïve men, warranting attention due to their unique presentation and clinical implications. This case report examines a rare occurrence of atypical femur fractures in a 73-year-old male with no prior bisphosphonate exposure.

Case Description: The patient, a 73-year-old male with no history of bisphosphonate use, presented with left thigh pain and swelling following a minor fall. Radiographic evaluation revealed a closed left mid diaphyseal femoral shaft fracture. Subsequent imaging identified an impending fracture in the contralateral femur. A comprehensive diagnostic assessment, incorporating radiographic analysis, laboratory tests, and clinical evaluation, confirmed the diagnosis. Surgical intervention via intramedullary nailing was performed for both fractures. Notably, the patient's medical history featured radiographic manifestations and the infrequent occurrence of atypical femur fractures in men, along with associated risk factors. Treatment included anabolic bone therapy utilizing teriparatide, coupled with discontinuation of anti-resorptive agents.

Discussions: This case highlights the importance of considering atypical femur fractures in older individuals with limited trauma history. It emphasizes the role of anabolic agents in the treatment plan and contributes to the evolving comprehension of atypical femur fractures. The findings underscore the necessity for vigilant monitoring and personalized management strategies in similar cases, thereby enhancing clinical practices and patient care.

Conclusions: In summary, this case report draws attention to atypical femur fractures in a bisphosphonate-naïve elderly male, shedding light on their diagnosis and management. It advocates for a comprehensive approach, involving anabolic therapy, and highlights the significance of tailored care in enhancing clinical practice and patient outcomes.