1) A study found that long-term use of alendronate (Fosamax) for osteoporosis may paradoxically increase the risk of subtrochanteric femoral fractures. 2) The study examined 22 patients with 34 fractures who had taken alendronate for 4-14 years. The fractures showed features including transverse orientation and lateral cortical thickening. 3) Radiologists need to recognize these fracture patterns and alert clinicians, as incomplete fractures may progress or require treatment changes given the risks of alendronate. Further research is needed to establish correlations and guidelines.