Increased incidence of hip fracture in osteoporotic women treated with sodium fluoride

J Bone Miner Res. 1989 Apr;4(2):223-5. doi: 10.1002/jbmr.5650040214.


There has been controversy as to whether fluoride therapy increases the risk of fracture in the appendicular skeleton. In the present study we compared the incidence of hip fracture in four groups of osteoporotic women: 22 treated with placebo, 17 with fluoride and calcium, 18 treated with fluoride and calcitriol, and 21 with calcitriol alone. Four hip fractures occurred in 3 patients on fluoride and calcitriol, and two hip fractures occurred in 2 patients on fluoride and calcium. No hip fractures occurred in patients receiving either calcitriol alone or placebo. The difference in fracture rates for fluoride versus nonfluoride treatment is significant (p = 0.006). Moreover, the six hip fractures occurring in patients receiving fluoride during 72.3 patient years of treatment is 10 times higher than would be expected in normal women of the same age. The probability of observing six fractures in 2 years is extremely small (0.0003). In four of the hip fracture cases, the history suggested a spontaneous fracture. These findings suggest that fluoride treatment can increase the risk of hip fracture in osteoporotic women.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Calcitriol / administration & dosage
  • Calcitriol / therapeutic use
  • Calcium / administration & dosage
  • Calcium / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Hip Fractures / epidemiology
  • Hip Fractures / etiology*
  • Humans
  • Menopause
  • Middle Aged
  • Osteoporosis / complications
  • Osteoporosis / drug therapy*
  • Sodium Fluoride / administration & dosage
  • Sodium Fluoride / adverse effects*


  • Sodium Fluoride
  • Calcitriol
  • Calcium