atypical femoral fracture in mccune-albright syndrome

Mccunealbright syndrome (mas) is characterized by endocrinopathies, caf eacute;aulait spots, and fibrous dysplasia. bisphosphonates are the most prescribed treatment for reducing the pain but their longterm use has been associated with atypical fractures of cortical bones like femur in patients. we present a 23yearold girl diagnosed with mas. she had an atypical midshaft left femoral fracture that happened during simple walking. she also had a history of longterm use of alendronate. because of the narrow medullary canal, we used 14 holes hybrid locking plate for the lateral aspect of the thigh to fix the fracture and 5 holes dynamic compression plate (instead of the intramedullary nail) in the anterior surface to double fix it, reducing the probability of device failure. with double plate fixation and discontinuation of alendronate, the complete union was achieved five months after surgery