Bilateral Femoral Neck Fracture Following an Epileptic Seizure in a Patient with Severe Vitamin D Deficiency: A Case Report.

Abstract

Simultaneous bilateral femoral neck fractures represent a rare entity and are usually associated with bone metabolism disorders, chronic steroid treatment, epileptic convulsions, or high-energy trauma. Here we report a case of bilateral femoral neck fracture in a patient with severe vitamin D deficiency following an epileptic seizure. Anteroposterior and lateral radiographs of the pelvis revealed Garden III femoral neck fractures on both hips. A single-stage operation involving bilateral uncemented bipolar hemiarthroplasties using the anterolateral approach was performed. Three months postoperatively, the patient was able to ambulate independently. Simultaneous bilateral femoral neck fractures following an epileptic seizure is a rare injury. In our case, severe vitamin D deficiency and chronic use of antiepileptics predisposed the patient to this condition. Orthopaedic surgeons and other clinicians should be aware of such an uncommon pathology. A multidisciplinary team approach is essential in identifying risk factors and optimizing inpatient management and postoperative rehabilitation. A single-stage bilateral procedure with an uncemented bipolar hip hemiarthroplasty in order to reduce cement disease in this frail patient has been successful in restoring functional capacity and allowing the patient to return to his preinjury ambulatory status.