[Sereda Andrey]

За последние пару месяцев попалось несколько сообщений/статей об атипичных, подвертельных переломах на фоне терапии остеопороза бисфосфонатами. А вот и в июльском номере JBJS флагманское мнение:
Review: Bisphosphonate Use and Atypical Femur Fractures: Fact or Fiction?
J Bone Joint Surg Am. 2011; 93:1-10 doi:10.2106/JBJS.OT.K.00025

Bisphosphonates, the major class of drugs used to treat osteoporosis, have been shown to diminish the risk of osteoporotic fractures. However, in the last several years, concerns have surfaced regarding the use of bisphosphonates. Specifically, there is concern about an increased risk of femoral stress fractures that occur with little or no trauma. The most common location is the subtrochanteric region, but fractures may occur along the diaphysis as well. Bilaterality has been reported, with rates ranging from as low as 4% to as high as 64%. A multidisciplinary task force of the American Society for Bone and Mineral Research has defined these “atypical femur fractures” in an attempt to help physicians identify patients with this type of atypical fracture.

Хотя, по моему скромному мнению, подвертельный перелом лучше перелома шейки бедренной кости.