Bilateral neck of femur fractures secondary to seizure

Brennan, Stephen; O’Neill, C.; Tarazi, Munir; Moran, R

doi:10.1136/practneurol-2013-000669

Cited by 10 publications

(9 citation statements)

References 2 publications

(2 reference statements)

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“…The fact that the average volume of admissions at San Gerardo University Hospital is approximately 32,000 patients per year confirms the rarity of bilateral femur fractures. The few cases of bilateral femoral neck fractures that have been reported in the elderly were associated with convulsive seizures [6][7][8][9][10], vitamin D deficiencies [11], fluoride treatment for osteoporosis [12], steroid treatment [13], celiac disease [14], mechanical stress [15,16], minimal traumas after a simple fall [17], and spontaneous fractures [18]. Several case reports were depicted among young patients, in which the bilateral femur fractures were associated with seizures [19][20][21][22], pharmaco-convulsive treatments [23], high-energy traumas [24], bone-related disorders [12,25,26], and electrical shock injuries [27][28][29].…”

Section: Discussionmentioning

confidence: 98%

Simultaneous bilateral femoral neck fracture and end-stage renal disease in a 76-year-old woman: a case report

et al. 2015

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Hip fracture is a common occurrence in the elderly. Due to the growing demand for the specific care of these patients, we established the Orthogeriatric Unit (OGU) at San Gerardo University Hospital (Italy) in 2007. However, simultaneous bilateral femoral neck fractures among the geriatric population (those aged ≥65 years) are rarely reported in the literature. Reporting the rare case of a frail 76-year-old woman admitted with bilateral hip fracture and end-stage renal disease, we explain the important role played by the OGU and its flexible multidisciplinary approach for providing comprehensive care to patients with multimorbidity and clinical complexity. The team of geriatricians, orthopedic surgeons, anesthesiologists, and, in this case, a nephrologist, helped in the careful planning and timing of the single-step surgical repair, decided the appropriate type of anesthesia, and optimized outcomes. After a prompt evaluation of the patient, the OGU approach can achieve clinical stabilization prior to intervention. Along with a strict follow-up in the postoperative phase, this could result in a significant reduction of complications and mortality rates and an early start to a tailored rehabilitation process. We strongly suggest employing facilities with multidisciplinary teams for cases involving complex patients at short-term high risk for poor clinical outcomes. Indeed, the usual single-specialist model of care is gradually being abandoned worldwide.

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Section: Discussionmentioning

confidence: 98%

Simultaneous bilateral femoral neck fracture and end-stage renal disease in a 76-year-old woman: a case report

et al. 2015

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“…In a minority of cases, several antiepileptic drugs are required to achieve seizure control (8). Non-traumatic fractures due to seizures themselves, especially caused by generalized tonic-clonic seizures, have been reported (9). If muscle contraction during a tonic-clonic seizure is strong enough to exceed bone strength, bone fractures could result (10).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Severe Osteoporosis and Preventive Therapy in RNA Polymerase III-Related Leukodystrophy

et al. 2021

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RNA polymerase III (POLR3)-related leukodystrophy is an autosomal recessive form of leukodystrophy caused by homozygous or compound heterozygous mutations of the RNA polymerase III subunit genes, including subunit A (POLR3A). With respect to the manifestation triad, hypomyelination, hypodontia, and hypogonadotropic hypogonadism, it is also known as 4H leukodystrophy. Here, we report a 41-year-old woman of POLR3-related leukodystrophy by carrying compound heterozygous pathogenic variants of c.2554A>G (p.M852V) and c.2668G>T (p.V890F) in the POLR3A gene. She was amenorrheic and became a wheelchair user from the age of 15 years and suffered from multiple episodes of pathologic fractures, starting with a subtrochanteric fracture of the right femur after a tonic seizure at age 30 years. Head magnetic resonance imaging demonstrated hypomyelination and atrophies of the cerebellum, brainstem, and corpus callosum. Laboratory examination revealed a marked decrease of gonadotropins and estrogen, low bone density, and high bone resorption markers. Administration of anti-receptor activator of nuclear factor kappa-B ligand monoclonal antibody restored bone resorption markers to a normal level and prevented further pathological bone fractures. Our case emphasizes that osteoporosis should be recognized as a potential but serious complication in POLR3-related leukodystrophy. It may be feasible to prevent pathologic fractures by intensive osteoporosis therapy after endocrinological examinations and evaluation of bone metabolism.

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“…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. Stress fractures of the bilateral femoral neck occasionally occur in young patients [20].…”

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 neck of femur fractures secondary to seizure

Cited by 10 publications

References 2 publications

Simultaneous bilateral femoral neck fracture and end-stage renal disease in a 76-year-old woman: a case report

Simultaneous bilateral femoral neck fracture and end-stage renal disease in a 76-year-old woman: a case report

Case Report: Severe Osteoporosis and Preventive Therapy in RNA Polymerase III-Related Leukodystrophy

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

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