Drugs such as Fosamox and Boneva are commonly prescribed to prevent fractures in patients with osteopenia and osteoporosis. Randomized trials have shown that long-term use (> 5 years) of these drugs can reduce the usual fractures that occur in old age. However, a large study reported in JAMA also showed that unusual fractures below the hip are increased somewhat with minimal trauma in patients who have used these drugs long-term. The authors suggest that long-term use of these drugs should be re-evaluated. In my experience, the more vigorous use of vitamin D, magnesium along with lower doses of calcium, natural progesterone, exercise, and sometimes strontium is often a better approach than reaching for the prescription pad for such patients.
See Park-Wyllie, et.al., JAMA, Feb. 23, 2011, p. 783-789.