Bilateral Femoral Neck Fractures Research Articles

Bilateral impacted femoral neck fracture in a renal disease patient.

Spontaneous bilateral femoral neck facture in a renal disease patient is not common. We report a case of 47-year-old female patient with chronic renal failure and on regular hemodialysis for the past 5 years who sustained bilateral impacted femoral neck fracture without history of trauma and injury and refused any surgical intervention. The patient was mobilised on wheel chair one year after the fractures. The cause of the fracture and the literature review of the bilateral femoral neck fracture in renal disease are discussed.

Atraumatic Bilateral Femoral Neck Fractures During Pregnancy

Case report A 37-year-old primigravid woman presented with bilateral anterior groin pain. The pain began spontaneously during the third trimester and became progressively worse, causing difficulty with walking. The most likely cause of her pain was thought to be pelvic instability, and conservative management was followed. No imaging studies were performed. Anterior pelvic pain continued unabated after a caesarean delivery at 38 weeks gestation. Plain radiographs were obtained four months after delivery and revealed bilateral displaced subcapital femoral neck fractures. CT scans showed well-corticated fractures on a background of osteopenia. The subcapital fracture on the right had united in a varus position. The fracture on the left was displaced with an 11-mm gap between fracture fragments. The femoral head was eroded, precluding open reduction and internal fixation. MRI of the pelvis showed increased signal on the short TI inversion recovery (STIR) image at the fracture sites, extending into the shafts of the proximal femora (Fig. 1). These findings most likely related to transient osteoporosis of pregnancy (TOP). Endocrinology review did not reveal a secondary cause for osteoporosis. Dual-energy X-ray absorptiometry later established a diagnosis of TOP with a z-score of )2.5. The delayed diagnosis of a displaced subcapital neck of femur fracture, on the left in this woman, necessitated treatment by total hip arthroplasty (Fig. 2). The impacted subcapital fracture on the right side was managed conservatively; however, this has left her with a short right lower limb. A corrective valgus osteotomy for the right hip is being considered as a future option to restore leg length.

Sjögren–Larsson syndrome – unusual presentation with pathological femoral neck fracture

Patients with Sjögren-Larsson syndrome, an autosomal recessive syndrome characterized by ichthyosis, spastic diplegia/quadriplegia, mental retardation and ocular features that include pigmentary changes in the retina, rarely present to the orthopaedic surgeon. We detail a rare and unusual presentation of Sjögren-Larsson syndrome in an adolescent boy with bilateral femoral neck fractures.

Bilateral Subcapital Femoral Neck Fractures Secondary to Transient Osteoporosis during Pregnancy: A Case Report

Transient osteoporosis during pregnancy is a rare, self-limiting disease. We report on a 36-year-old woman who had bilateral subcapital femoral neck fractures during the 6th month of pregnancy. The diagnosis was made 4 days after delivery, because radiography was declined by the patient for fear of radiation. Fixation was not feasible owing to bone resorption, and 2-stage bipolar hemiarthroplasty was therefore performed. Magnetic resonance imaging is the best non-invasive investigative tool for pregnant women with hip pain. Early detection can prevent complications and resorting to major surgeries.

Case Report: Bilateral Femoral Neck Fractures in a Child and a Rare Complication of Slipped Capital Epiphysis After Internal Fixation

Bilateral traumatic femoral neck fractures are uncommon in children. The most commonly reported complications are nonunion, avascular necrosis of the femoral head, and chondrolysis. Slipped capital femoral epiphysis (SCFE) associated with nonunion after percutaneous partially threaded cancellous screw (PTCS) fixation of the fracture is an unreported complication. We describe a 10-year-old boy who had bilateral femoral neck fractures secondary to a fall from a height. The patient was treated with percutaneous PTCS fixation on both sides and achieved union on the right side in 3months, however, a nonunion and SCFE developed on the left side 5months after the initial surgery. Management of the nonunion and SCFE with PTCS and nonvascularized fibula graft led to union. Eighteen months after the initial injury, the patient achieved a pain and limp-free gait. A literature review shows avascular necrosis, posttraumatic coxa vara, premature physeal closure, nonunion, chondrolysis, infection, and implant failure as complications of operative management of femoral neck fractures. SCFE has not been previously reported. This case highlights the need for close followup of adolescent patients with PTCS fixation for femoral neck fractures.

Spontaneous simultaneous bilateral femoral neck fractures secondary to osteomalacia: a case report and review of the literature.

We present a case of spontaneous simultaneous bilateral hip fracture in an elderly female patient suffering undiagnosed osteomalacia. She underwent staged bilateral cemented bipolar hemiarthroplasty and received long-term medical treatment for osteomalacia. Our aim is to stress on the clinical value of unexplained chronic bilateral groin pain predicting the occurrence of these fractures and on the importance of evaluating serum levels of vitamin D, calcium and parathyroid hormone especially in elderly sedentary patients with lack of exposure to sunlight.

Atraumatic bilateral femoral neck fractures during pregnancy: A missed diagnosis

Australian and New Zealand Journal of Obstetrics and GynaecologyVolume 51, Issue 6 p. 563-564 Case Reports Atraumatic bilateral femoral neck fractures during pregnancy: A missed diagnosis Matthew L. BROADHEAD, Matthew L. BROADHEAD Department of Orthopaedics and University of Melbourne Department of SurgerySearch for more papers by this authorSina BABAZADEH, Sina BABAZADEH Department of Orthopaedics and University of Melbourne Department of SurgerySearch for more papers by this authorKong Wah NG, Kong Wah NG Department of Endocrinology and Diabetes, St Vincent’s Hospital Melbourne, Fitzroy, Victoria, AustraliaSearch for more papers by this authorPeter F.M. CHOONG, Peter F.M. CHOONG Department of Orthopaedics and University of Melbourne Department of SurgerySearch for more papers by this authorJames D. STONEY, James D. STONEY Department of Orthopaedics and University of Melbourne Department of SurgerySearch for more papers by this author Matthew L. BROADHEAD, Matthew L. BROADHEAD Department of Orthopaedics and University of Melbourne Department of SurgerySearch for more papers by this authorSina BABAZADEH, Sina BABAZADEH Department of Orthopaedics and University of Melbourne Department of SurgerySearch for more papers by this authorKong Wah NG, Kong Wah NG Department of Endocrinology and Diabetes, St Vincent’s Hospital Melbourne, Fitzroy, Victoria, AustraliaSearch for more papers by this authorPeter F.M. CHOONG, Peter F.M. CHOONG Department of Orthopaedics and University of Melbourne Department of SurgerySearch for more papers by this authorJames D. STONEY, James D. STONEY Department of Orthopaedics and University of Melbourne Department of SurgerySearch for more papers by this author First published: 10 October 2011 https://doi.org/10.1111/j.1479-828X.2011.01366.xCitations: 3 Mr James D. Stoney, Department of Orthopaedics, St Vincent’s Hospital Melbourne, Level 3, Daly Wing, 35 Victoria Parade, Fitzroy, Vic. 3065, Australia. Email: jamesstoney@iinet.net.au Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume51, Issue6December 2011Pages 563-564 RelatedInformation

Simultaneous bilateral femoral neck stress fractures in a young military cadet: a rare case report.

Simultaneous bilateral femoral neck stress fracture in healthy young adult is one of the very rare clinical entities that an orthopedic surgeon may encounter once in lifetime. Bilateral femoral neck stress fractures have been very well documented in elderly and osteomalacia patients; however, its simultaneous occurrence in a healthy adult is challenging to diagnose and manage. This article describes a 34-year-old man a military personnel who sustained bilateral stress femoral neck fractures, during a routine training activity. The patient was come to our institution, and a full endocrine evaluation was performed and proved unremarkable. He underwent closed reduction and internal fixation of the fractures using cannulated screws on both the sides. At 1-year follow-up, the fractures went on to complete union. Despite strict non-weight-bearing instructions for initial 3-month period, patient bore weight on the limbs resulting in varus union on the left side. Our case emphasizes the significance of obtaining a complete and thorough medical history on physical examination and appropriately counseling patients regarding activity level even after successful fixation.

Bilateral femoral neck fracture in a child

A long-term follow-up of bilateral femoral neck fracture is presented. The patient sustained the injury in a road accident at the age of five. Both fractures were Delbet type III. Three days after the injury, open reduction and internal fixation were performed. A hip spica cast was applied for 8 weeks. Follow-up radiographs show uneventful healing, with no avascular necrosis of the femoral head. The initial shortening of the right proximal femur persisted. The left femur shows extensive remodeling of the femoral head toward valgus. The patient is painless and currently does some sports.

Bilateral Femoral Neck Fracture-Related Hyperparathyroidism

Bilateral femoral neck fracture is not common as unilateral femoral fracture. Femoral neck fracture generally occurs by the high energized traumas. Traffic accidents and fallings are the most common reason for this fracture kind. But suddenly and minor traumatic fractures is not common. Especially, in the hormonal and pathogenic fractures is not common. In this case minor traumatic bilateral femoral fracture is presented. The fracture occurs in the background of critical medical condition by hyperparathyroidism. It can be said chronic hyperparathyroidism conditions must be determined for femoral neck fracture. Because these patients many times fell little disturbed by this fracture, diagnosis can be missed many times.

Experimental studies on treatment of femoral neckf racture by unproved internal fixation

Objective To observe the therapeutic effect of treating femoral neck fracture after improved the fixation methods. Methods The bilateral femoral neck fractures model of 18 goats were resulted by operation. The experimental side was fixed using a modified method, and the control side was fixed using the traditional internal fixation techniques. The three-phase radionuclide bone imaging examination was performed 5 times in the pre- and 4,6,8,12 weeks after operation. The femoral head and neck of the goats which were killed in the 4,8,12 weeks after operation were observated by histology. And the treatment effect of femoral neck fractures with modified fixation was evaluated through X-ray examination. Results(1) Blood flow and pool curve showed the blood flow in the artery and the vein of the experimental side was better than that of the control side. Radionuclide bone imaging appear the femoral head blood flow and me-tabolization rate of the experimental side was higher than that of the control side. In the 4th,6thweek after the operation,the bone tissue repaired process was quickly in the experimental side. (2) Histology observation results show that the vascular remodeling and woven bone formation in the experiment side was more rapid than thatof the control side. The clearance of necrosis bone chips in the experiment sidewas accelerated. Conclusion The modified fixation method which in the basis of increasing the stability reduced the intramedullary pressure of femoral neck and protected the residual blood supply, which was conducive to fracture healing, the early reconstruction of femoral head blood supply and promoting bone tissue repair. Key words: Femoral neck fracture; Healing; Femoral head necrosis; Internal fixation; Improvement

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

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.

Bilateral Simultaneous Femoral Neck Fractures Secondary to a Post-infarct Generalized Tonic-clonic Seizure. A Case Report

Bilateral femoral neck fractures are generally associated with high-energy trauma or defects in bone metabolism. We present a patient who had not been subjected to high-energy trauma and in whom there was no bone metabolism disorder.

Bilateral femoral neck fractures resulting from a grand mal seizure in an elderly man with Down syndrome

Simultaneous bilateral hip fractures are exceedingly rare and usually occur following a seizure. To our knowledge, only 22 cases of such injuries have been reported in the literature during the past forty years and the majority of fractures are treated with open reduction and internal fixation. We present a case of a 66-year old man with Down syndrome and severe dementia who was diagnosed with bilateral displaced femoral neck fractures following an epileptic seizure. He was treated with single staged bilateral uncemented monopolar hemi-arthroplasties through lateral Hardinge approaches. The treatment choice was governed by fracture displacement, the lack of pre-existing osteoarthritis, length of time to diagnosis, the patient's age, ambulatory status and mental impairment, with the intention to minimize post-operative complications such as avascular necrosis, non-union and hip dislocation.

Progressive course of hypophosphatemic osteomalacia during 25-year follow up

Hypophosphatemic osteomalacia is defined as mineralization of the newly formed bone matrix (osteoids) in adults as a consequence of the phosphate deficiency. A female from Belgrade, aged 62 years fell ill in 1982. when she was 36. She first felt pains in bones associated with chronic fatigue. In 1986. during her hospitalization the presence of neoplastic hematologic, endocrinologic, urogenital and gastroenterologic system deseases was excluded. Hypophosphatemic osteomalacia was diagnosed on the basis of the history, clinical presentation, physical examination, radiologic finding and laboratory analyses (lower serum phosphorus level). The initial therapy included a mixture of phosphates, vitamin D and calcium. The doses were several times corrected over the following four years. In 1990 she had a mild clinical deterioration requiring recorrection of the mentioned therapy. In 1993 bilateral femoral neck fractures occurred and subsequent osetosynthe as was performed. The disease had a progressive character in spite of the administered drug therapy so that multiple fractures occurred in 2000. During the last hospitalization in 2008. neither new pseudo fractures nor fractures were found although biochemical profile of the hypophosphatemic osteomalacia was still present. The aim of this study was to emphasize the complexity in both diagnostic and therapeutic approach in the case of hypophosphatemic osteomalacia. In the presented case the patient showed a complicated and progressive course. In our opinion such course was a consequence of impossible etiologic treatment and discontinued therapy

Simultaneous Bilateral Femoral Neck Fracture in a Patient with Osteoporosis- A Case Report

We report a case of bilateral neck of femur fracture in a patient in osteoporotic bone, as a result of a fall from a standing position. A literature review shows all similar fractures are documented to have been associated with high velocity trauma, seizures and/or osteoporosis secondary to steroid use. As far as we are aware this is the first reported case of this fracture pattern in connection with this patient profile and history, which is similar to the vast majority of trauma patients seen.

Simultaneous bilateral femoral neck fractures secondary to epileptic seizures: Treatment by bilateral total hip arthroplasty

Simultaneous bilateral femoral neck fracture following an epileptic seizure attack are rare. Open reduction and internal fixation remains the most used therapeutic option. Arthroplasty, carrying a high risk of dislocation is less often recommended. We report the favourable evolution of a 49-year-old man who benefited from a single stage bilateral total hip arthroplasty operation for his simultaneous bilateral, femoral neck fractures secondary to a generalized seizure. This nonconsensual choice, in this case, was justified on multiple grounds: surgical care delay longer than 48 hours, substantial bone displacement, borderline bone quality, adequate antiepileptic treatment efficacy and tolerance. A ceramic-on-ceramic bearing surfaces couple, a large-diameter head and a cementless implantation design together should be able to provide an acceptable longevity in a young and active patient.

P106 Pregnancy with associated osteoporosis and bilateral femoral neck fracture

P106 Pregnancy with associated osteoporosis and bilateral femoral neck fracture

Bilateral simultaneous femoral neck fractures in a child

Bilateral femoral neck fracture is a rare injury, mostly seen in adults often with bony and metabolic disorders. This injury occurs very rarely in children and only few of it have been reported. A 4-year-old child with direct pelvic trauma and bilateral femoral neck fractures is reported in whom early surgical treatment was successful. Bilateral femoral neck fracture is extremely rare in children, but in patients with pelvis trauma it should be suspected and the radiograms should be carefully reviewed.

Bilateral femoral neck fractures in an adult male following minimal trauma after a simple mechanical fall: a case report

BackgroundDespite being rare there are several reports in the medical literature of bilateral femoral neck fractures in adult patients. They have been reported to have occurred following major trauma, or as a result of primary or secondary bone disease. In this case report we describe for the first time in the literature bilateral femoral neck fractures in a patient following minimal trauma after a simple mechanical fall.Case presentationWe describe the case of an 84-year-old gentleman who sustained bilateral intracapsular fractures following a simple mechanical fall. Prompt diagnosis and early surgical intervention resulted in a satisfactory outcome.ConclusionThis case highlights that in the elderly, even in the absence of primary and secondary bone disease, bilateral neck of femur fractures can occur following relatively minor trauma. Consequently, the orthopaedic surgeon, emergency physician and general practitioner should be aware of this injury, particularly when managing traumatic injuries in confused patients.