<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2306-4102</journal-id>
<journal-title><![CDATA[Acta ortopédica mexicana]]></journal-title>
<abbrev-journal-title><![CDATA[Acta ortop. mex]]></abbrev-journal-title>
<issn>2306-4102</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Ortopedia y Traumatología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2306-41022019000100039</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Atypical femoral fracture, case report and literature review]]></article-title>
<article-title xml:lang="es"><![CDATA[Fractura atípica del fémur, reporte de caso y revisión de la literatura]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cleto-Zepeda]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Durán-Martínez]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tena-Sanabria]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General Xoco  ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro Medico Dalinde Orthopedics and Traumatology Department ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Unidad Médica de Alta Especialidad Centro Medico Nacional Siglo XXI]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>02</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>02</month>
<year>2019</year>
</pub-date>
<volume>33</volume>
<numero>1</numero>
<fpage>39</fpage>
<lpage>41</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2306-41022019000100039&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2306-41022019000100039&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2306-41022019000100039&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Bisphosphonates have been the gold standard in the management of osteoporosis. Its antiresorptive effect has reduced the incidence of fractures due to bone fragility, as well as its impact on public health. We present the clinical case of a patient in prolonged treatment with bisphosphonates and atypical bilateral femur fracture.  Case report:  A 65-year-old female who presented a fall from her own height, on treatment with risedronate for seven years, and a history of systemic arterial hypertension and hypercholesterolemia, both with medical treatment. Diagnosed with bilateral atypical femoral fracture, treated with closed reduction internal fixation (CRIF) with intramedullary nailing, application of calcium citrate and teriparatide.  Discussion:  Multiple studies indicate that the benefit of using bisphosphonates for osteoporosis is higher than the risk of presenting atypical fractures.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  Los bifosfonatos han sido de gran utilidad en el manejo de la osteoporosis. Su efecto antirresortivo ha disminuido la incidencia de fracturas por fragilidad ósea, así como, su impacto en salud pública. Presentamos el caso clínico de una usuaria en tratamiento prolongado con bifosfonatos y fractura atípica de fémur bilateral.  Caso clínico:  Femenino de 65 años, presenta caía de su plano de sustentación, en tratamiento con risedronato desde hace siete años y antecedente de hipertensión arterial sistémica e hipercolesterolemia, ambas con manejo médico. Diagnosticada con fractura bilateral de fémur, tratada con enclavado centro-medular, citrato de calcio y teriparatida.  Discusión:  Múltiples estudios refieren que el beneficio del uso de bifosfonatos en la prevención del riesgo de fracturas es mayor, aunque exista la posibilidad de presentar fracturas atípicas.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Atypical fractures]]></kwd>
<kwd lng="en"><![CDATA[osteoporosis]]></kwd>
<kwd lng="en"><![CDATA[bisphosphonates]]></kwd>
<kwd lng="en"><![CDATA[teriparatide]]></kwd>
<kwd lng="en"><![CDATA[nail]]></kwd>
<kwd lng="es"><![CDATA[Fracturas atípicas]]></kwd>
<kwd lng="es"><![CDATA[osteoporosis]]></kwd>
<kwd lng="es"><![CDATA[bifosfonatos]]></kwd>
<kwd lng="es"><![CDATA[teripartida]]></kwd>
<kwd lng="es"><![CDATA[clavo]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Iqbal]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Osteoporosis: epidemiology, diagnosis, and treatment]]></article-title>
<source><![CDATA[South Med J]]></source>
<year>2000</year>
<volume>93</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>2-18</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Im]]></surname>
<given-names><![CDATA[GI]]></given-names>
</name>
<name>
<surname><![CDATA[Jeong]]></surname>
<given-names><![CDATA[SH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pathogenesis, management and prevention of atypical femoral fractures]]></article-title>
<source><![CDATA[J Bone Metab]]></source>
<year>2015</year>
<volume>22</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>1-8</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Edwards]]></surname>
<given-names><![CDATA[BJ]]></given-names>
</name>
<name>
<surname><![CDATA[Bunta]]></surname>
<given-names><![CDATA[AD]]></given-names>
</name>
<name>
<surname><![CDATA[Lane]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Odvina]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Rao]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
<name>
<surname><![CDATA[Raisch]]></surname>
<given-names><![CDATA[DW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Bisphosphonates and nonhealing femoral fractures: analysis of the FDA Adverse Event Reporting System (FAERS) and international safety efforts: a systematic review from the Research on Adverse Drug Events And Reports (RADAR) project]]></article-title>
<source><![CDATA[J Bone Joint Surg Am]]></source>
<year>2013</year>
<volume>95</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>297-307</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bubbear]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atypical femur fractures in patients treated with bisphosphonates: identification, management, and prevention]]></article-title>
<source><![CDATA[Rambam Maimonides Med J]]></source>
<year>2016</year>
<volume>7</volume>
<numero>4</numero>
<issue>4</issue>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Geissler]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Bajaj]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Fritton]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[American Society of Biomechanics Journal of Biomechanics Award 2013: cortical bone tissue mechanical quality and biological mechanisms possibly underlying atypical fractures]]></article-title>
<source><![CDATA[J Biomech]]></source>
<year>2015</year>
<volume>48</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>883-94</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Shane]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Burr]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Abrahamsen]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Adler]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Brown]]></surname>
<given-names><![CDATA[TD]]></given-names>
</name>
<name>
<surname><![CDATA[Cheung]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research]]></article-title>
<source><![CDATA[J Bone Miner Res]]></source>
<year>2014</year>
<volume>29</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>1-23</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Takemoto]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
<name>
<surname><![CDATA[McLaurin]]></surname>
<given-names><![CDATA[TM]]></given-names>
</name>
<name>
<surname><![CDATA[Tejwani]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Egol]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evolution of atypical femur fractures and the association with bisphosphonates]]></article-title>
<source><![CDATA[Bull Hosp Jt Dis (2013)]]></source>
<year>2014</year>
<volume>72</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>104-9</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Odvina]]></surname>
<given-names><![CDATA[CV]]></given-names>
</name>
<name>
<surname><![CDATA[Zerwekh]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Rao]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
<name>
<surname><![CDATA[Maalouf]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Gottschalk]]></surname>
<given-names><![CDATA[FA]]></given-names>
</name>
<name>
<surname><![CDATA[Pak]]></surname>
<given-names><![CDATA[CY]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Severely suppressed bone turnover: a potential complication of alendronate therapy]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2005</year>
<volume>90</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>1294-301</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Saita]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Ishijima]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kaneko]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atypical femoral fractures and bisphosphonate use: current evidence and clinical implications]]></article-title>
<source><![CDATA[Ther Adv Chronic Dis]]></source>
<year>2015</year>
<volume>6</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>185-93</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Caeiro-Rey]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Etxebarria-Foronda]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Mesa-Ramos]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fracturas atípicas relacionadas con el uso prolongado de bifosfonatos. Estado de la situación]]></article-title>
<source><![CDATA[Rev Esp Cir Ortop Traumatol]]></source>
<year>2011</year>
<volume>55</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>392-404</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Adler]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[El-Hajj Fuleihan]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Bauer]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Camacho]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
<name>
<surname><![CDATA[Clarke]]></surname>
<given-names><![CDATA[BL]]></given-names>
</name>
<name>
<surname><![CDATA[Clines]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Managing osteoporosis in patients on long-term bisphosphonate treatment: report of a task force of the American Society for Bone and Mineral Research]]></article-title>
<source><![CDATA[J Bone Miner Res]]></source>
<year>2016</year>
<volume>31</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>16-35</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Im]]></surname>
<given-names><![CDATA[GI]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[SH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effect of teriparatide on healing of atypical femoral fractures: a systemic review]]></article-title>
<source><![CDATA[J Bone Metab]]></source>
<year>2015</year>
<volume>22</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>183-9</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
