AP radiograph of the proximal femur showing a complete subtrochanteric fracture
The case
73-year-old woman, 8 years on alendronate, several weeks of right thigh pain, then a low-energy fall. This is her radiograph. What is the diagnosis, and how would you manage her (and the other side)?
Reveal the model answertap to expand
Atypical femoral fracture (subtrochanteric, transverse). Stop the bisphosphonate, optimise calcium/vitamin D, fix (cephalomedullary nail), and image the contralateral femur — AFFs are frequently bilateral.
Subtrochanteric/diaphyseal transverse fracture with lateral beaking
