Fig. 1.

a, b Preoperative images of a patient on chronic antiresorptive therapy presenting to an outside facility with an AFF. Notice the atypical fracture pattern and contralateral beaking (arrow). c Images after fracture fixation with cephalomedullary device of the right femur only. Pt eventually presented with a nonunion of the right femur and left hip pain d, e After revision open reduction and internal fixation of the right femur, the left side underwent a prophylactic cephalomedullary nailing