Femoral subtrochanteric insufficiency fracture after long-term bisphosphonate therapy masked from foraminal stenosis of lumbar spine -A case report

• Published in: Anesthesia and pain medicine (Korean society of anesthesiologists) pp. 170 - 173
• Main Authors: 김정은, 김봉일, 김종해, 류태하, 성현진, 조명래
• Format: Journal Article
• Language: English
• Published: 대한마취통증의학회 01.07.2014
• Subjects: 마취과학
• ISSN: 1975-5171; 2383-7977

We present a case of an insufficiency fracture of the subtrochantericregion of the femur in a 78-year-old woman masked by lumbar spinalforaminal stenosis. She complained of pain and a tingling sensationin the anterior and lateral side of the right thigh, leg, and ankle. Selective transforaminal epidural (L4-5, Rt.) and caudal block weredone under the diagnosis of lumbar foraminal stenosis. The tinglingsensation was completely relieved, but the pain was not completelyrelieved. The patient had been receiving bisphosphonate therapyfor 6 years under the diagnosis of osteoporosis. We performedmagnetic resonance imaging, which showed a unicortical break lineand marrow edema around the hypertrophied area. Surgery wasdone. In cases with incomplete relief of the pain in the thighfollowing epidural block, physicians should keep in mind thepossibility of femoral insufficiency fracture in patients who havereceived long-term bisphosphonate therapy. KCI Citation Count: 0