Evidence map›Paper›PMID 40506101›Full record

ArticleBMJ case reports2025

Bisphosphonate beak without the bisphosphonate: atypical femoral fracture with denosumab.

Alwaleed Alabbasi, Darren P Moloney, Costel M Murariu, Sami U Khan

Abstract readCase Reports
In one paragraph

Article in BMJ case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Bone health in patients with cancer: a SEOM-SEIOMM consensus review of risk factors, assessment strategies, and management approaches.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Alwaleed AlabbasiRoyal College of Surgeons in Ireland, Dublin, Ireland.ORCID http://orcid.org/0009-0003-3988-2143
Darren P MoloneyRoyal College of Surgeons in Ireland, Dublin, Ireland DarrenPMoloney@rcsi.ie.ORCID http://orcid.org/0000-0002-6530-1467
Costel M MurariuRoyal College of Surgeons in Ireland, Dublin, Ireland.
Sami U KhanTrauma and Orthopaedic Department, Beaumont Hospital, Dublin, Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Atypical femur fractures (AFFs) are rare complications of antiresorptive therapies like denosumab, resulting from suppressed bone remodelling. These fractures occur with minimal or no trauma and are often preceded by prodromal thigh or groin pain. Radiographically, they present as transverse or short oblique fractures with lateral cortical thickening and minimal comminution.We report a case of an elderly bisphosphonate-naïve patient on denosumab who developed a subtrochanteric AFF. The patient underwent intramedullary nailing, denosumab was discontinued, and a transition to bisphosphonates was planned after 6 months to reduce the risk of rebound vertebral fractures. Histological analysis confirmed cortical bone fragments with no malignancy, consistent with AFF pathology.This case highlights the importance of early recognition of AFFs, appropriate surgical intervention and careful management of antiresorptive therapies. It also highlights the need for vigilant monitoring in long-term denosumab patients and provides valuable insights into the management of these fractures.

Indexed as

Bone Density Conservation AgentsDenosumabFemoral FracturesAged, 80 and overDiphosphonatesFemaleFracture Fixation, IntramedullaryHumansBone Density Conservation AgentsDenosumabDiphosphonatesFracture Fixation, IntramedullaryIntramedullary NailingOrthopaedics

Identifiers

PMID40506101
PMCPMC12161004

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.