Repeated falls and broken bones

A 72 year old woman attended the emergency department because of a painful right hip after a fall the day before. She had been unable to get up from the floor, and had lain there until she was found by her son. She had broken her left wrist three years ago after a fall outside her house. This had been managed conservatively. She was taking antihypertensives but no other drugs and rarely drank alcohol. She lived alone and was independent for activities of daily living. She was independently mobile within and outside the house but could not walk long distances. She was otherwise in good health. She had pain in the right groin and was unable to move her leg. On examination, she had no localised bruising and her right leg was shortened and externally rotated. She could not raise the leg. She had no pain anywhere else and physical examination was otherwise unremarkable. A radiograph showed an intertrochanteric fracture of the right neck of the femur, which was treated with surgery.