Bilateral spontaneous fracturing of the femoral neck in a patient with renal osteodystrophy

Garcia, Flávio Luís; Dalio, Renato Bellini; Sugo, Arthur Tomotaka; Picado, Celso Hermínio Ferraz

doi:10.1016/j.rboe.2014.07.004

Cited by 9 publications

(8 citation statements)

References 8 publications

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“…However, only few case reports [6, 7] and studies [8, 9] specifically focus on fractures in end-stage renal disease (ESRD) patients. In Chinese ESRD patients, fragility fractures remain uncharacterized, with the underlying mechanisms and risk factors undefined.…”

Section: Introductionmentioning

confidence: 99%

Factors and Outcome of Renal Osteodystrophy-Associated Initial Fragility Fracture in End-Stage Renal Disease Patients

et al. 2019

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Background: Renal osteodystrophy has caused increased risk of fragility fracture in end-stage renal disease (ESRD) patients. However, risk factors and outcome of ESRD patients with fragility fracture remain uncharacterized. We aimed to assess these parameters in ESRD patients. Summary: This retrospective case-control study analyzed 354 ESRD patients (initial fragility fracture [FF] group, n = 59; control group, n = 295). Pre-dialysis blood hemoglobin, serum albumin, lipid, calcium, phosphorus, alkaline phosphatase (ALP), and intact parathyroid hormone (iPTH) were collected. All procedures performed involving human participants were in accordance with the ethical standards of the institutional committee of The First Affiliated Hospital of Chongqing Medical University (IRB approval number 216-82), and informed consent was obtained from all participants. There were higher prevalence rates of primary hypertension and diabetes, higher serum ALP, corrected calcium, and lower serum total cholesterol, low-density lipoprotein, lipoprotein-α, and iPTH in the FF group. Fractures were more likely to occur in the higher level of corrected calcium as well as in the lower iPTH group. High corrected calcium (p = 0.010, OR = 11.308, 95% CI: 1.770–72.242) and serum ALP (p = 0.000, OR = 1.007, 95% CI: 1.004–1.011) were independent risk factors of fragility fracture. The incidence of all-cause mortality and cardiovascular (CV) events in ESRD patients with fragility fracture was higher than in those without fracture. Key Messages: Patients with hypertension, diabetes, excessive suppression of PTH, and poor nutritional status are more prone to fractures. Serum corrected calcium and ALP were independent risk factors of fragility fracture. Patients with initial fragility fracture had more CV events and higher mortality.

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Section: Introductionmentioning

confidence: 99%

Factors and Outcome of Renal Osteodystrophy-Associated Initial Fragility Fracture in End-Stage Renal Disease Patients

et al. 2019

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“…The decompensated period of chronic renal failure is accompanied by electrolyte and metabolic disorders, and multiple organ system dysfunctions [ 4 ]. Renal-related osteodystrophy predisposes to osteoporosis, osteomalacia and spontaneous fractures [ 5 , 6 ]. Most hip fractures associated with chronic renal failure occur in the elderly.…”

Section: Introductionmentioning

confidence: 99%

Damage Control Orthopedics Management as Vital Procedure in Elderly Patients with Femoral Neck Fractures Complicated with Chronic Renal Failure: A Retrospective Cohort Study

Dong

Wang

et al. 2016

PLoS ONE

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BackgroundChronic renal failure (CRF) predisposes to hip fractures in elderly patients, with high subsequent mortality. Selection and timing of the surgical procedure of such patients is a serious challenge. Many clinicians believe in earlier surgery as preferable and providing better outcomes. Damage control orthopedics (DCO) aids to adjust and optimize the overall condition of patients.MethodsIn 32 patients with femoral neck fractures complicated with CRF, we evaluated how the timing of the surgery determines the mortality rates if the DCO approach is applied. Preoperative ASA grading, POSSUM score, P-POSSUM score and DCO were carried out. Based on the assessment, timing of the surgery was ascertained.ResultsOf a total of 32 patients, twenty-nine patients were accepted for either early (< 48 hours; n = 18) or delayed (3–10 days; n = 10) surgery. Hip arthroplasty (total hip arthroplasty and hemiarthroplasty) was the principal surgery option. All patients survived operation and were followed up postoperatively with the average time of 30 days. Postoperative complications tended to occur at higher rates in the early vs. delayed surgery group (7/18 vs. 5/10). During follow up, a total of 3 patients died in both groups (2/18 in the early surgery and 1/10 in the delayed surgery group), mostly from multi-organ failures and acute respiratory distress syndrome. There was no significant difference in complication rates and Harris hip score between both groups.ConclusionIn patients with femoral neck fracture complicated with CRF, delaying the surgery for several days does not increase the incidence of postoperative adverse events.

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“…SBFNFs in patients on dialysis are relatively rare. To the best of our knowledge, only 10 cases have been reported previously, making our case the 11th (Table 1) [1,[5][6][7][8][9][10][11][12][13][14]. SBFNFs are usually secondary to seizure disorders [15], trauma [16], electric shock injuries [17], hypovitaminosis D [18], osteoporosis [19], and metabolic diseases.…”

Section: Discussionmentioning

confidence: 99%

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

Zhu

Han

et al. 2020

BMC Musculoskelet Disord

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Background: Simultaneous 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 presentation: We 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. Conclusions: A 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.

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Bilateral spontaneous fracturing of the femoral neck in a patient with renal osteodystrophy

Cited by 9 publications

References 8 publications

Factors and Outcome of Renal Osteodystrophy-Associated Initial Fragility Fracture in End-Stage Renal Disease Patients

Factors and Outcome of Renal Osteodystrophy-Associated Initial Fragility Fracture in End-Stage Renal Disease Patients

Damage Control Orthopedics Management as Vital Procedure in Elderly Patients with Femoral Neck Fractures Complicated with Chronic Renal Failure: A Retrospective Cohort Study

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

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