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Atypical Femoral Fracture (AFF) Score of Min et al

Description

Min et al developed a score for identifying a patient with an incomplete atypical femoral fracture that may progress to a complete fracture. This can help to identify a patient who may benefit from more aggressive management. The authors are from Keimyung University, Seoul National University, and Kyungpook National University in South Korea.

 


Patient selection: bisphosphonate therapy with incomplete atypical femoral fracture

 

Outcome: complete fracture

 

Parameters:

(1) site

(2) pain

(3) contralateral femur

(4) radiographic change

 

Parameter

Finding

Points

site

subtrochanteric

3

 

diaphyseal

2

 

other

1

pain

none

1

 

mild (nonfunctional)

2

 

"functional"

3

contralateral femur

complete fracture

1

 

incomplete fracture

2

 

intact

3

radiographic change

focal cortical change

1

 

radiolucent line less than one half

2

 

radiolucent line >= one half

3

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 4

• maximum score: 12

• The higher the score the greater the risk of a complete fracture.

• A patient with a score < 8 can be managed conservatively. A score >= 8 identifies a patient who requires prophylactic fixation.

 

Score

Percent Complete Fracture

4 to 5

0%

6 or 7

8%

8

15%

9

23%

10

62%

11

77%

12

100%

 


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