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

Zhu, Yunyun; Hu, Jingtao; Han, Wei; Lu, Jian; Zeng, Yuqing

doi:10.1186/s12891-020-03281-7

Cited by 8 publications

(12 citation statements)

References 34 publications

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“…On the contrary, bilateral simultaneous hip fractures are rare and often occur in young patients due to high-energy trauma [ 1 ], seizures [ 2 ], and metabolic diseases [ 3 ]. These fractures have also been reported in patients treated with bisphosphonates and are usually atypical subtrochanteric fractures [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

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Bilateral simultaneous asymmetric hip fracture without major trauma in an elderly patient: a case report

et al. 2022

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Background Simultaneous bilateral hip fractures without major trauma in the elderly are rare and usually symmetrical. To the best of our knowledge, only two cases of bilateral simultaneous asymmetric hip fracture in the elderly without major trauma have been reported. Case presentation We present the case of a 90-year-old Japanese man with simultaneous bilateral asymmetric hip fractures with trochanteric fracture on the right side and greater trochanteric fracture on the left side. He complained of dyspnea at midnight and was referred to our emergency department. He was admitted to the internal medicine department for bacterial pneumonia treatment. On the 8th day of hospitalization, he was referred to our orthopedic surgery department for hip pain and was found to have fractures of both hips. Computed tomography findings showed that the left femoral neck fracture was an old fracture, while the left greater trochanteric fracture and the right trochanteric fracture were fresh fractures. He was surgically treated through open reduction and internal fixation with an intramedullary nail on the right and hemiarthroplasty on the left in supine position, performed during the same surgical sessions on the 12th day of hospitalization. Conclusions We report a new form of simultaneous bilateral asymmetric hip fracture in the elderly. The fracture types of the case were femoral trochanteric fracture and greater trochanteric fracture of the femur, which were different from the fracture types in the previously reported two cases. Clinicians should be aware of the possibility of simultaneous bilateral hip fractures, especially in the elderly.

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Section: Discussionmentioning

confidence: 99%

“…Simultaneous bilateral hip fractures are usually associated with high-energy trauma [ 1 ], seizures [ 2 ], metabolic disorders [ 3 ], and the use of bisphosphonates [ 4 ]. They are rarely observed in the elderly after simple trauma and usually have the same fracture pattern (symmetric) [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Bilateral simultaneous asymmetric hip fracture without major trauma in an elderly patient: a case report

et al. 2022

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“…Hormone suppression following, corticosteroid treatments, for example, can lead to loss of bone density in men. Among the metabolic conditions found in patients with bilateral femoral neck fractures, the works reviewed in this study mostly emphasize hypocalcemia [ 21 , 22 , 23 , 25 ] and renal failure, with dialysis where it was the case [ 22 , 34 , 35 , 36 , 37 ]. Case 2, which we presented here, adds to this category of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Previously published studies show that hip fractures in patients dependent on dialysis are 4.4 times greater than in the general population [ 34 , 35 ], with an incidence of 29.3/1000 people per year [ 36 ]. This information relates to unilateral hip fractures, as bilateral ones are still very rare [ 37 ].…”

Section: Case Presentationmentioning

confidence: 99%

Energy, Waves, and Forces in Bilateral Fracture of the Femoral Necks: Two Case Presentations and Updated Critical Review

Baciu

2022

Diagnostics

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Two case reports and an updated critical review on bilateral fractures of the femoral neck are presented. Bilateral fractures of the femoral neck have been investigated for at least 80 years and are treated as rare cases. The primary cause is usually considered an external shock; however, aside from high energy shocks (e.g., falling and impact with hard, rigid surfaces, traffic accidents, etc.) the underlying causes of femoral neck frailty have not yet been fully understood. Although not exhaustive, the review spans cases reported as early as 1944 and compares their conclusions in line with medicine developments at the time of the reports until present. The discussion is perhaps controversial at times; it brings to the fore the energy balance between shock waves and stress waves. The two cases reported here add to the review, one highlighting the biomechanics, and the other supporting more recent findings on metabolic disorders, which ultimately lead to enhanced frailty of the femoral neck. Investigation of the fractures has been performed with X-ray radiographs, MRI, and CT, with a follow up using a Doppler US to check blood flow in the lower zone of the limbs. The second case was investigated both for fractures and metabolic diseases, e.g., type I diabetes and kidney failure (dialysis). In Case 1 the second fracture was not observable at the time of admission, and therefore two surgery operations were performed at seven days interval. Taperloc Complete prostheses (Zimmer Biomet) were applied. Case 2 suffered a second fracture in the right hip in the segment above the knee and required better fixation with cables. Despite this, she returned one month later with a new crack in the femur. Case 1 is a typical case of wear consequences on the biomechanics of the hill pad-tibia-femur-femoral neck system, where tension of the neck occurred due to a stress wave rather than a shock wave. This can be proven by the absence of a second fracture from the images first acquired, the only evidence being pain and walking difficulty. Case 2 shows that metabolic diseases can dramatically enhance the frequency of bilateral femoral neck fractures.

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“…They are characterized by the highest degree of rotational instability among hip fractures 11,12 . Based on our reviews, there were several reports of bilateral femoral neck fractures 10,13–19 . However, simultaneous bilateral basicervical femoral neck fractures have never been reported.…”

Section: Introductionmentioning

confidence: 86%

Simultaneous bilateral basicervical femoral neck fractures in a patient with osteomalacia: A case report and literature review

Yokogawa,

Nagira,

Yonei

et al. 2023

Clinical Case Reports

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

Cited by 8 publications

References 34 publications

Bilateral simultaneous asymmetric hip fracture without major trauma in an elderly patient: a case report

Bilateral simultaneous asymmetric hip fracture without major trauma in an elderly patient: a case report

Energy, Waves, and Forces in Bilateral Fracture of the Femoral Necks: Two Case Presentations and Updated Critical Review

Simultaneous bilateral basicervical femoral neck fractures in a patient with osteomalacia: A case report and literature review

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