Journal of Osteoporosis and Physical Activity
Open Access

Abstract

Non-Union of a Tibial Stress Fracture in a Young Female Taking Bisphosphonate Medication

Jonathan Evans, Daniel William and Mark Norton

The authors present the case of a 27 yr old female who failed conservative management for a tibial stress fracture. The patient was known to suffer from “Female Athlete Triad” and as a consequence of decreased bone mineral density had been started on long-term bisphosphonates. Though this medication has been proposed as a treatment for stress fractures, an anabolic homeostatic bone state is required; this is known to be deficient in the presence of eating disorder and low body mass index. A non-fibrous atrophic non-union was found at the time of surgery. The patient has responded well to operative fixation including bone graft and modification of risk factors, which included stopping bisphosphonate therapy.