Fracture Disease is rare avascular necrosis following the immobilization of fractures occurs often in older and inactive age groups secondary to sympathetic over activity around the immobilized parts. No standard of treatment still exists for treating early stages of AVN, of the cases eventually progressing to a late arthritic stage needing surgical intervention. Bisphosphonates have been shown to prevent disease progression, bone collapse, and the requirement for surgery in avascular necrosis of bone following immobilization of fracture commonly around wrist and hand. The present study is conducted to evaluate the response of bisphosphonates in the l management of the early stages of AVN following fracture disease which usually is untreated where pt presents with stiffness and swelling around the hand and finger and foot. Materials and methods: Prospectively collected data of 80 patients diagnosed with an fracture disease and treated with the combination of intravenous zolendronic acid (ZA) with calcium supplementation for 2-3 consecutive years year, between Jan 2016 to Dec 2018, was evaluated retrospectively. Clinical evaluation was done using the visual analogue scale (VAS), mean analgesic requirement, and range of motion. Radiographs were taken to monitor radiological collapse, and evaluate radiological progression and bone marrow and cortical changes at regular intervals of 6 moths each, changes were categorized based on clinical evolution of progress in osteosynthesis based on regular wt bearing and active mobilization of the affected part. Results: In our analysis of 80 patients (9 lost to follow-up), 55 patients had fracture disease around the wrist and 53 patients were treated by osteopaths and 2 by casts, and 25 patients had fracture disease around the foot and metatarsal head were treated by osteopaths. Pain relief with the drop in VAS score was seen at a mean duration of 6-8 weeks (range 5–15 weeks) after the start of therapy. ZOLendronate ..............