FEBRUARY 2015 |Volume38•Number2 n Case Report abstract Figure: Preoperative anteroposterior radiograph of the right hip and femur. Bisphosphonates are the most commonly prescribed drugs to treat osteoporosis because they have been proposed to prevent bone loss. Nevertheless, in up to 0.1% of patients, long-term use may cause atypical stress or insufficiency femoral fractures. Bilateral femoral shaft fractures have been reported after long-term use of bisphosphonates; however, there is limited evidence of the effect of short-term use. The current study reports a case of bilateral femoral fractures after a low-ener- gy fall in a 56-year-old woman and provides a review of the literature on bilateral femoral shaft fractures after long-term use of bisphosphonates. Patients should be educated about the potential for stress fractures with the use of this treatment. In patients with thigh pain, a thorough history and physical examination, including the contralateral thigh, may be beneficial to detect bilateral traumatic or atypical stress fracture patterns. More studies with larger sample sizes are necessary to better identify patients who may be at risk for fracture, including histomorpho- metric evidence of low bone turnover in patients with unfortunate bilateral cases. [Orthopedics. 2015; 38(2):e139-e142.] The authors are from the Department of Orthopaedic Surgery, Seton Hall University, School of Health and Medical Sciences, Paterson, New Jersey. The authors have no relevant financial relationships to disclose. Correspondence should be addressed to: Aiman Rifai, DO, Seton Hall University, School of Health and Medical Sciences. St. Joseph’s Regional Medical Center, 703 Main St, Paterson, NJ 07503 (arrifai@optonline.net). Received: April 11, 2014; Accepted: June 24, 2014. doi: 10.3928/01477447-20150204-90 Bilateral Femur Fractures Associated With Short-term Bisphosphonate Use AIMAN RIFAI, DO; SINA POURTAHERI, MD; ANDREW CARBONE, BS; JOHN J. CALLAGHAN, MD; CHRIS M. STADLER, MD; NICOLE RECORD, DO; KIMONA ISSA, MD e139