Neglected simultaneous bilateral femoral neck fractures secondary to narcotic drug abuse treated by bilateral one-staged hemiarthroplasty: a case report

Alireza Hootkani,Ehsan Vahedi,Ali Moradi

doi:10.1186/1749-799x-5-41

Alireza Hootkani, Ehsan Vahedi + Show 1 more

Open Access

https://doi.org/10.1186/1749-799x-5-41

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Abstract

Simultaneous bilateral femoral neck fractures are extremely rare and associated with various conditions. Up to now Most cases had correlations with major trauma, repetitive minor trauma, seizure, parathyroid or renal dysfunction, anti-epileptic medications, seizure, etc. A 28-year-old addict man referred to us with a 10-year history of narcotic drug abuse and history of 8 months bilateral groin pain. He admitted with displaced bilateral femoral neck fracture. Because of long duration of this condition and osteonecrosis revealed on bone scan, one-staged bilateral hip hemiarthroplasty was done. A good function was noted after surgery to 4-month follow up. Up to now, have not be founded in the literature that a case of bilateral femoral neck fracture associated with narcotic drug abuse.Because of negative effects of opium or smoking on bone tissues, a simple bone pain should aware us about the risk of stress or fatigue fracture.

Highlights

Simultaneous bilateral femoral neck fractures are extremely rare and have been associated with highenergy trauma [1], repetitive minor trauma, abnormal anatomy [2], seizure [3,4,5,6,7,8,9], electrical injury, electroconvulsive therapy, primary or secondary bone diseases such as osteomalacia [10], hyperparathyroidism [11], chronic renal failure [12], or severe osteoporosis especially after corticosteroid or other corticosteroid-like drug therapy
We present a case of bilateral femoral neck fractures with prolonged history of narcotic drug
Hip Stress fractures of most frequently involve the medial aspect of femoral neck

Summary

Background

Simultaneous bilateral femoral neck fractures are extremely rare and have been associated with highenergy trauma [1], repetitive minor trauma, abnormal anatomy [2], seizure [3,4,5,6,7,8,9], electrical injury, electroconvulsive therapy, primary or secondary bone diseases such as osteomalacia [10], hyperparathyroidism [11], chronic renal failure [12], or severe osteoporosis especially after corticosteroid or other corticosteroid-like drug therapy. Case presentation A 28-yr-old addict man was referred to our institution with an 8 month history of chronic pain in both groins aggravated by weight bearing sometimes keeping him awake at night. He had previously normal activities without specific sport or job program. After 8-month, because of low socio-economic state and not appropriate follow-up by him, the patient was referred to us with displaced bilateral hip fractures (Fig-2). On examination, his weight was 65 kilograms and both active and passive motions were painful and restricted. The patient had normal range of motion in both hips and was capable of doing daily activities after 24 weeks of follow up

Discussion

Conclusions