Bisphosphonate-related bilateral femoral fractures
Diagnosis certain
Disclosures
- updated 6 Dec 2022:
Nothing to disclose
Updates to Quizquestion Attributes
Answer
was added:
"Transverse fracture of the middle third of the right femoral diaphysis with medial beaking.
In the absence of appropriate trauma, atypical femoral fracture is likely and radiographs of the contralateral femur have been arranged to assess for incomplete fractures."
Telephone the caring team to explain and arrange orthogonal radiographs of the entire left femur, as bilateral atypical fractures are common and occur anywhere from the lesser trochanter to the supracondylar flare. The patient may also need reassurance and an explanation.
Bisphosphonates should be ceased as they increase the likelihood of atypical femoral fracture 50-fold.
The orthopaedic team may prophylactically fix the incomplete fracture with an intramedullary nail as well as nailing the completed fracture.
Question
was added:
Clinical indications: "Acute on chronic pain of several weeks duration. Non weight-bearing."
Provide a written report and describe your actions.
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