Abstract
An 82-year-old woman had been taking alendronate for 5 years and 5 months, which had been prescribed for osteoporosis at a local clinic. Severe left thigh pain began without any trauma. X-ray, computed tomography and magnetic resonance imaging findings showed atypical femoral fracture(AFF). Treatment with teriparatide and weight-bearing therapy was selected. Bone union was achieved without surgery. Teriparatide has been reported to promote AFF healing. At four years and 9 months from the beginning of treatment, our patient has no left femoral pain and no impairment to activities of daily living. Careful follow-up will be necessary as long-term outcomes of conservative AFF treatment have not been reported to date.