Surgical strategy of the treatment of atypical femoral fractures

Figure 2 Images of an 81-year-old woman who had taken bisphosphonate for two years. A: An 81-year-old woman who had taken bisphosphonate for two years visited the outpatient clinic complaining of left thigh pain for two months. Radiographs revealed a transverse beak and radiolucent line (white arrows) on the lateral and anterior cortex of the right femur with 10° of varus and 7° of anterior angulation. According to a scoring system[11], the risk for impending complete atypical femoral fracture was scored as 11 points; B: She underwent fixation with an opposite-side (right side) standard nail (Sirus Femoral Nail^®, Zimmer, Warsaw, IN, USA). Prophylactic screw fixation toward the femoral neck on her left femur was performed to prevent potential femoral neck fracture around the nail.