Simultaneous Bilateral Femoral Neck Research Articles

"Simultaneous Bilateral Femoral Neck Fractures Due to Vitamin D Deficiency and Chronic Ankle Instability in a Young Adult -- A Case Report and Literature Review"

"Simultaneous Bilateral Femoral Neck Fractures Due to Vitamin D Deficiency and Chronic Ankle Instability in a Young Adult -- A Case Report and Literature Review"

Simultaneous Bilateral Femoral Neck and Proximal Humeral Fractures - Floating Members: A Case Report

Simultaneous Bilateral Femoral Neck and Proximal Humeral Fractures - Floating Members: A Case Report

Simultaneous Bilateral Femoral Neck Fracture Due to a Tonic-Clonic Seizure and High-Dose Steroid Therapy

Simultaneous bilateral femoral neck fractures (FNFs) are extremely rare and usually associated with an underlying condition affecting the bone quality and mineralization. Convulsions have also been described as a possible cause, mostly as a consequence of epilepsy, hyponatremia, and hypocalcemia. We present a 52-year-old female patient, with bilateral displaced FNFs due to a tonic-clonic seizure and high-dose steroid therapy related to a frontal lobe anaplastic oligodendroglioma brain tumor resection. Two days after admission, bilateral one-stage uncemented total hip arthroplasty (THA) under general anesthesia and through a posterolateral approach was performed using a metal-on-polyethylene bearing surface. Several risk factors can be identified in this unique case, such as the high-dose steroid therapy, the low-demand activity of the patient due to her functional sequelae, and finally, the convulsive episode. Surgeons should be aware of this uncommon injury to ensure early diagnosis and treatment in all patients with a previous history of seizures, chronic steroid use, severe hip pain, and inability to walk. For bone metabolic diseases, preventive measures should be indicated to avoid these complications. Bilateral one-stage uncemented THA represents an effective procedure with a low complication rate allowing early rehabilitation.

Simultaneous bilateral femoral neck fractures in a dialysis-dependent patient: case report and literature review

BackgroundSimultaneous bilateral femoral neck fractures are extremely rare without obvious injury. Herein, we report the case of a patient on dialysis presenting with bilateral femoral neck fractures, which is a condition with high complication and mortality rates according to a review of the pertinent literature.Case presentationWe report the case a 47-year-old female with a history of 8 years of haemodialysis due to polycystic kidney disease who presented with bilateral hip pain during walking. The clinical history and results of physical and radiographic examinations of this patient are shown. Single-stage bilateral hemiarthroplasty was performed after a multidisciplinary team consultation. Three days after the operation, she could ambulate with a walker. The woman gradually regained her previous ability to walk over 6 months after surgery.ConclusionsA multidisciplinary team consultation for perioperative management is necessary and effective in patients on dialysis. Early diagnosis with prompt surgical treatment could lead to favourable recovery.

Low-velocity simultaneous bilateral femoral neck fracture following long-term antiepileptic therapy: A case report

Low-velocity simultaneous bilateral femoral neck fracture following long-term antiepileptic therapy: A case report

Spontaneous bilateral femoral neck fractures in a young male adult: a case report and literature review

BackgroundSimultaneous bilateral femoral neck fracture is a very rare condition, even in osteoporotic elderly individuals. We report an atypical case of a young male adult who developed simultaneous bilateral femoral neck fractures without previous trauma or overuse.Case presentationA 33-year-old man presented with discomfort in the bilateral groin, which had started 2 weeks previously. Bilateral femoral neck fractures were observed on a radiograph, and in addition, a fracture line was seen at the right subchondral region of the acetabulum using magnetic resonance imaging (MRI). Although the patient had no obvious risk factors associated with bone fragility, his bone mineral density measured using dual X-ray absorptiometry indicated severe osteoporosis (lumber spine: T score − 3.4 standard deviation [SD]; femoral neck: T score − 2.8 SD). Serum 25-hydroxyvitamin D level was deficient (19 ng/mL), which was considered to be partly due to non-sunlight exposure for 3 years owing to social withdrawal. Bilateral osteosynthesis was performed, considering his young age, although more than 2 weeks had passed since the onset of the fracture. Bone union and non-occurrence of osteonecrosis of the femoral head were confirmed via radiography and MRI 8 months after the surgery.ConclusionsOur case suggests that simultaneous non-traumatic bilateral femoral neck fractures can occur in healthy young men.

Simultaneous bilateral neck of femur fractures in an adolescent secondary to hypocalcaemic seizure

We present a rare case of a previously healthy 16-year-old boy who sustained simultaneous bilateral femoral neck fractures after a single first-time seizure episode. He was diagnosed to have severe vitamin D deficiency and secondary hyperparathyroidism. Symptomatic hypocalcemia was the cause of seizures. Both fractures were treated surgically and united at 3 months. Bilateral femoral neck fractures after seizures are very rare, especially in children. Severe vitamin D deficiency may cause seizures and also weakening of bone, predisposing to fractures without significant trauma. We recommend that paediatric cases of femoral neck fractures after seizures should be investigated for underlying metabolic disease.

Simultaneous bilateral femoral neck stress fractures in a young female runner: A case report and review of literature

Fatigue fractures generally appear in normal bone following increased repetitive activity or strenuous exercise, when imbalance occurs between applied force and elastic resistance. Femoral neck fatigue fractures are most common in athletes and young military recruits. They are not as common as stress fractures of the metatarsals or tibia and other bones. This paper reports bilateral stress fractures of the femoral neck in a 14-year-old girl presenting with pain in the anterior aspect of the right thigh of 3 months duration and without evidence of previous injury with low Vitamin D and elevated parathyroid hormone levels. Correction of Vitamin D levels, bed rest, and relief of weight-bearing were indicated as fractures were undisplaced.

Simultaneous bilateral femoral neck fractures following electroconvulsive therapy

Fracture neck of femur occurs commonly among elderly people with osteoporosis being the risk factor favoring its occurrence. Its occurrence among young adults, though uncommon, follows high-energy trauma with multisystem affectation. Fracture neck of femur poses a management challenge to the surgeon in deciding on the best option of treatment, in achieving accurate reduction and fixation, and in dealing with complications which may be inevitable. Fracture neck of femur following electroconvulsive therapy is rare. Simultaneous bilateral femoral neck fractures following electroconvulsive therapy are even rarer. Simultaneous bilateral femoral neck fractures management is technically demanding, requiring considerable experience, appropriate instrumentation, and equipment. It is also associated with high morbidity which includes nonunion and avascular necrosis. These fractures can be prevented by the use of modified electroconvulsive therapy. This case seeks to reemphasize the rarity of simultaneous bilateral femoral neck fractures following electroconvulsive therapy, highlight the challenges of managing this condition and proffer ways of avoiding its occurrence.

Simultaneous bilateral femoral neck fracture following tetanus in a healthy adult

A 45-year-old trader presented to us with 4 weeks history of difficulty in opening his mouth, inability to walk and tonic–clonic seizures with bilateral femoral neck fractures. Three weeks before the onset of problems, the patient had been knocked down by a tricycle and had sustained an open wound over the right medial malleolus; the wound was sutured at a general hospital and the patient discharged home. One week later, the wound started discharging a foul-smelling pus and was dressed at a primary health centre; however, by the second week, the patient started having difficulty in opening his mouth. By the third week, he was bed ridden, developed tonic–clonic seizures and felt a crunching sound associated with severe pain in both hips. He was taken to a traditional bone setter who gave him some herbs, but his symptoms got worse. He was then brought to the Accident and Emergency Department of the University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria where a diagnosis of tetanus was made. Further evaluation revealed Gardener-type IV bilateral femoral neck fractures. He was managed for the tetanus, underwent bilateral bipolar hemiarthroplasty and was discharged home. He spent 10 weeks in the hospital.

Simultaneous Bilateral Femoral Neck Fractures with an L1 Burst Fracture Treated Using One-stage Bilateral Hemiarthroplasty: A Case Report

Simultaneous bilateral femoral neck fractures are extremely rare. This report presents a description of an 82-year-old woman who did not exhibit any systemic disease and complained of bilateral hip pain after slipping and falling to a sitting position. She was admitted with a displaced bilateral femoral neck fracture. A one-stage bilateral hip hemiarthroplasty was performed. The patient also complained of lower back pain after surgery. The L1 burst fracture remained and was conservatively treated using a back brace. The patient's postoperative function was satisfactory following surgery, and remained satisfactory until an 8-month follow-up. Because force is typically transmitted to one side in a simple fall, this is the first report of a simultaneous bilateral femoral neck fracture with an L1 burst fracture that was not caused by a medical condition or drug use.

Bilateral simultaneous femoral neck fracture mimicking abdominal pain in a cerebral palsy patient.

Simultaneous bilateral femoral neck fractures are unusual lesions, generally associated with an underlying condition which causes impaired bone mineralization, triggered by an increased bone stress. We present a 24-year-old cerebral palsy patient, who was previously evaluated in another institution due to inability to walk, interpreted as abdominal pain. No alteration in blood analysis or abdominal X-rays was found. As no response to treatment was observed, a new abdominal X-ray was taken, which incidentally depicted bilateral medial femoral neck fracture. He was referred to our practice after a resection arthroplasty was offered in another institution. After admission, bilateral one-stage THA was performed. Several reports emphasize bone disease as a major precipitating factor, and there is an increased incidence of hip fractures in chronic epilepsy, renal osteodystrophy, and chronic steroid use. Femoral head resection has been proven to be effective in immobilized patients, whereas this was not a reasonable option in this patient who presented walking ability. Despite the treatment election, primary care physicians should be aware of and alert to the possibility of fractures in patients with neurological disorders and calcium metabolism alterations. Late diagnosis of orthopedic injuries in this type of patients may lead to permanent disability.

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.

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.

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.

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.

Simultaneous Bilateral Femoral Head and Neck Ostectomy for the Treatment of Canine Hip Dysplasia

Simultaneous bilateral femoral head and neck ostectomy (FHO) was performed on 15 dogs for severe bilateral hip dysplasia. A follow-up survey was performed 6 to 48 months after surgery to assess the postoperative recovery and activity levels of the operated dogs. All dogs had normal activity levels and were pain free according to their owners. Owner satisfaction regarding the outcome of the surgery was high. Simultaneous bilateral FHO was a viable surgical option for the treatment of painful bilateral hip disease in dogs, especially when other surgical options were not indicated or were cost prohibitive.

Bilateral pathologic fractures of the hip and acetabulum treated with cementless total hip arthroplasty

Pathologic fractures from metastatic cancer pose formidable challenges to the orthopaedic surgeon technically and in terms of surgical decision making with regards to patient quality of life. We present the case of a 47-year-old woman with simultaneous bilateral pathologic femoral neck and acetabulum fractures and severe pulmonary shunt, who was treated successfully with cementless femoral and acetabular implants. Copyright 2002, Elsevier Science (USA). All rights reserved.

Stimultaneous bilateral fractures of the neck of the femur.

Cases are reported of two men who sustained bilateral hip injuries while undergoing convulsive therapy and of one woman who sustained bilateral hip injuries during a uraemic convulsion. A further twenty-three previously unreported cases are analysed, sixteen of which were of simultaneous bilateral femoral neck fractures and five of which were simultaneous bilateral central dislocations of the hip. One other patient sustained his injuries in an epileptic fit. A review of the literature has revealed another thirty-five cases of bilateral hip injuries, most of them caused by convulsive therapy, but a few by accident, disease of the femoral neck, or epilepsy. One case is included of a rare double injury, a femoral neck fracture on one side and a central dislocation on the other. I have found no previous reference to this combined injury. Double hip injuries are very rare in relation to the large numbers of patients receiving convulsion therapy, but the change from pharmacological to electrical methods has not prevented their occurrence and at least fifteen are known to have occurred during the last six years. A wide age range is represented, and many fractures of convulsive origin have occurred in fit, well nourished, adult men. Only a few have been found in more elderly and possibly osteoporotic patients. All the "convulsive " injuries were sustained during unmodified treatment, and mention is made of the differences of opinion among psychiatrists about the use of anaesthesia and of relaxant drugs in convulsion therapy. These are the most severe injuries complicating convulsion therapy, and the most difficult for the orthopaedic surgeon to treat.