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Histological examination of a specimen of the bone showed severe fluorosis in the first case, and quantitative analysis of bone showed osteomalacia and skeletal fluorosis in the other case. These abnormalities were considered to be the consequence of excessive retention of fluoride due to renal insufficiency. As bilateral femoral neck fractures are very rare these data suggest a causal link between fractures and fluoride in patients with renal failure. Thus fluoride should be given at a lower dosage, if at all, to patients with even mild renal failure.<\/jats:p>","DOI":"10.1136\/bmj.287.6394.723","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"723-725","source":"Crossref","is-referenced-by-count":57,"title":["Bilateral fractures of femoral neck in patients with moderate renal failure receiving fluoride for spinal osteoporosis."],"prefix":"10.1136","volume":"287","author":[{"given":"J C","family":"Gerster","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S A","family":"Charhon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Jaeger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Boivin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Briancon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Rostan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C A","family":"Baud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P J","family":"Meunier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1983,9,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1056\/NEJM198202253060802","article-title":"Effect of the fluoride\/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis","volume":"306","author":"Riggs, B.L.; Seeman, E.; Hodgson, S.F.; Taves, D.R.; O'Fallon, W.M.","year":"1982","unstructured":"Riggs BL, Seeman E, Hodgson SF, Taves DR, O'Fallon WM. Effect of the fluoride\/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis. N EnglJ3 Med 1982;306:446-50.","journal-title":"N EnglJ3 Med"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0030-5898(20)31375-4","article-title":"Treatment of osteoporosis with fluoride, calcium and vitamin D","volume":"12","author":"Briancon, D.; Meunier, P.J.","year":"1981","unstructured":"Briancon D, Meunier PJ. Treatment of osteoporosis with fluoride, calcium and vitamin D. Orthop Clin North Am 1981;12:629-48.","journal-title":"Orthop Clin North Am"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1001\/jama.1966.03100110130044","article-title":"Induction of skeletal fluorosis in two common demineralizing disorders","author":"Cohen, P.; Gardner, F.H.","year":"1966","unstructured":"Cohen P, Gardner FH. Induction of skeletal fluorosis in two common demineralizing disorders. 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