Atypical Fracture of Proximal Ulna Associated with
Prolonged Bisphosphonate Therapy Managed with
Nonoperative Treatment: A
Case Report: and Literature
Review
Konlawat Sabsuantang MD¹ , ², Nachapan Pengrung MD², Norachart Sirisreetreerux MD², Noratep Kulachote MD², Paphon Sa-ngasoongsong MD, MCh²
Affiliation : ¹ Chakri Naruebodindra Medical Institute, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ² Department of Orthopedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Prolonged bisphosphonate (BP) treatment is associated with some complications, such as atypical femoral fractures (AFFs). Recent studies showed
that atypical fractures also occurred in other bones, especially in the atypical fracture of the proximal ulna (AFPU). Although, AFPUs frequently
share the same characteristics of atypical fractures as AFFs, such as fracture configuration and high risk of non-union, there is still limited evidence
of the role of non-operative treatment in AFPU. The aim of the present study was to present an interesting case involving an 80-year-old female
presented with non-displaced AFPU after receiving long-term BP medication and had been treated with a conservative method for 2.5 years, and
to review the literature regarding the available AFPU treatment options. To the best of the authors’ knowledge, the present case report introduced
new insight of the outcome of non-operative treatment for AFPU.
Received 22 February 2021 | Revised 30 July 2021 | Accepted 5 August 2021
doi.org/10.35755/jmedassocthai.2021.09.12593
Keywords : Non-displaced fracture; Ulna fracture; Long-term bisphosphonates; Conservative treatment; Nonunion; Osteoporosis
