Osteomalacia and coxa vara. An unusual co-existence for femoral neck stress fracture

Abstract

HighlightsFemoral neck stress fractures are not uncommon.Osteomalacia is a common cause of insufficiency fractures.Coxa vara is a rare cause of femoral neck stress fractures.Co-existence of osteomalacia and coxa vara is a rare condition.

Bilateral Femoral Neck Stress Fracture in an Obese Middle-Aged Female With Osteomalacia and Coxa-Vara Managed by Simultaneous Bilateral Total Hip Arthroplasty

“…Stress fractures occur due to repetitive loading leading to mechanical failure of the bone. Such injuries occur either due to abnormal stresses on a normal bone (fatigue fractures) or normal stresses on an abnormal bone (insufficiency fractures) [4,[6][7][8].…”

“…Fatigue fractures occur in the normal bone of a healthy individual as a result of excessive and repetitive loading. These fractures are common to athletes, dancers, and military personnel [4,7]. Insufficiency fractures occur in the weak bone under normal loading.…”

“…Insufficiency fractures occur in the weak bone under normal loading. There are several risk factors for these fractures such as osteoporosis, osteomalacia, long-term corticosteroid and anticonvulsant treatment, renal osteodystrophy, amenorrhea, fluoride treatment, and pelvic irradiation [4][5][6][7]9].…”

Total Hip Arthroplasty for Bilateral Femoral Neck Stress Fracture: A Case Report and Review of the Literature

“…Cases of bilateral femoral neck fractures, even simultaneous, have been reported in healthy military recruits [5][6][7][8][9] as well as in healthy nonathletes [10,11]. Insufficiency or fatigue bilateral fractures of the femoral neck have been described in various conditions such as pregnancy [12]; bone metabolic diseases, caused by osteomalacia associated with coxa vara [13] or by celiac disease [14]; vitamin D deficiency [15]; and rare genetic syndromes like Marfan [16] and autosomal dominant osteopetrosis [17]. Other more common risk factors, such as steroid treatment [18,19] and anorexia nervosa [20], have also been involved in cases of bilateral insufficiency femoral neck fractures.…”

Early diagnosis of femoral neck stress fractures may decrease incidence of bilateral progression and surgical interventions: A case report and literature review

“…Insufficiency types occur when normal stress is put on abnormal bone [ 3 ]. Interestingly, many risk factors in the elderly for insufficiency types have been reported including osteoporosis, osteomalacia, long-term corticosteroid use, bisphosphonate use, and vitamin D deficiency [ [4] , [5] , [6] ]. Our patient mirrored these risk factors with vitamin D deficiency, osteoporosis, and bisphosphonate use.…”