Introduction: Denosumab reduces the osteoporotic fracture risks. Concerns regarding the rare side effects of antiresorptive therapies, such as atypical femur fracture, have contributed to the underuse of osteoporosis drugs.
Objective: To present a clinical case to recognize clinical characteristics, diagnosis, and management of an atypical femoral fracture due to the use of denosumab.
Case presentation: An 83-year-old female patient with osteoporosis at high fracture risk under management with zoledronic acid for five years with worsening bone mineral density, implementing denosumab, with three doses, presenting an atypical femoral fracture.
Discussion and conclusion: The efficacy of denosumab in reducing the risk of fractures in patients with a high risk of fractures is evident. There is significant uncertainty about how to treat patients after they have suffered an atypical femur fracture. Antiresorptive therapy's benefit in managing osteoporosis is greater than the risk of presenting an adverse event derived from antiresorptive therapy. Medical management with anabolic therapy is an alternative to osteoporosis treatment in this group of patients.
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