Case contributed by: Dr Patsy Robertson
Story Source

Presentation:
78 year old female, thigh pain following a fall from a car
Patient Data:
Age: 78
Gender: Female

Displaced subtrochanteric fracture of the left femur. The left hip is enlocated. Note is made of the widening of the lateral cortex proximal and distal to the fracture. Incompletely imaged right femoral gamma nail.
Case Discussion:
The subtrochanteric region is a less common site for fragility fractures but a more common site for fractures in those who have been on long term bisphosphonates (> 5 years). Thickening of the cortex is a feature seen in stress fractures. Involvement of the lateral cortex is more typical with bisphosphonate related fractures whereas stress fractures associated with osteomalacia tend to involve the medial cortex.

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Bisphosphonate related proximal femoral fractures