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Bones of the Lower Limb: Femur and Patella01:16

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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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The upper and lower limb initially develops as a small bulge called a limb bud, which appears on the lateral side of the early embryo. The upper limb bud appears near the end of the fourth week of development, with the lower limb bud appearing shortly after.
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Updated: Feb 24, 2026

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Mortality Following Atypical Femoral Fractures in Men.

Colton Hoffer1, Wiliam Obremskey2, Binni Makker1

  • 1Medical College of Georgia at Augusta University.

Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
|February 23, 2026
PubMed
Summary

Atypical femoral fractures (AFFs) in men treated with bisphosphonates (BPs) showed lower 5-year mortality compared to hip or shaft fractures. However, small sample sizes may limit definitive conclusions on AFF mortality differences.

Keywords:
atypical femoral fractureship fracturesmortalityosteoporosis

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Area of Science:

  • Orthopedics
  • Pharmacology
  • Geriatrics

Background:

  • Atypical femoral fractures (AFFs) are rare complications of long-term bisphosphonate (BP) therapy for osteoporosis.
  • Previous studies on AFF mortality have primarily focused on women and included limited male populations.

Purpose of the Study:

  • To investigate and compare mortality rates among men who experienced AFFs, hip fractures, or typical subtrochanteric/femoral shaft (ST/FS) fractures after bisphosphonate treatment.

Main Methods:

  • Retrospective cohort study of men from the Veterans Affairs Corporate Data Warehouse with BP prescriptions.
  • Fracture classification using ICD codes and radiographic review for AFFs based on ASBMR 2014 criteria.
  • Analysis of demographic data, clinical characteristics, and BP exposure duration.

Main Results:

  • Over 5 years, mortality was 30% for AFFs (n=23), 52% for hip fractures (n=4,591), and 48% for ST/FS fractures (n=225).
  • Initial 12-month mortality was 4% for AFFs vs. 25% for hip and 15% for ST/FS fractures.
  • Cox proportional models showed no statistically significant difference in 5-year mortality between AFFs and other fracture types, potentially due to small AFF sample size.

Conclusions:

  • While observed mortality rates suggest potentially lower risk following AFFs in men, the limited number of AFF cases prevents definitive conclusions.
  • Further research with larger male cohorts is needed to confirm potential mortality benefits of AFFs over other fracture types in bisphosphonate users.