Skip to main content

Table 1 2013 ASBMR task force criteria of atypical femoral fractures

From: Management of atypical femoral fracture: a scoping review and comprehensive algorithm

ASBMR criteria: Four of five major criteria should be observed; additional minor criteria are not necessary for diagnosis but could be observed in association to the major criteria.
Major - The fracture is associated with minimal or no trauma, as in a fall from a standing height or less
- The fracture line originates at the lateral cortex and is substantially transverse in its orientation, although it may become oblique as it progresses medially across the femur
- Complete fractures extend through both cortices and may be associated with a medial spike; incomplete fractures involve only the lateral cortex
- The fracture is noncomminuted or minimally comminuted
- Localized periosteal or endosteal thickening of the lateral cortex is present at the fracture site (“beaking” or “flaring”)
Minor criteria - Generalized increase in cortical thickness of the femoral diaphyses
- Unilateral or bilateral prodromal symptoms such as dull or aching pain in the groin or thigh
- Bilateral incomplete or complete femoral diaphysis fractures
- Delayed fracture healing
  1. Fractures of the femoral neck, intertrochanteric fractures with spiral subtrochanteric extension, periprosthetic fractures, and pathological fractures associated with primary or metastatic bone tumors and miscellaneous bone diseases (eg, Paget’s disease, fibrous dysplasia) are excluded [12]