Spontaneous bilateral displaced femoral neck fractures in nutritional osteomalacia--a case report

Simultaneous, Bilateral Pathological Displaced Intracapsular Hip Fractures Occurring Spontaneously Secondary to Osteomalacia of Hypomagnesemic Origin: A Case Report and Review of the Literature

“…Osteomalacia is a well-recognized cause of femoral neck fractures [14] which may be bilateral on occasion [2,9,15]. The most common cause of osteomalacia is vitamin D deficiency due to an inadequate diet and a lack of sun exposure.…”

“…Other causes include renal, vitamin D resistance, liver diseases, and drugs. Due to improper mineralization, pseudofractures of the bones occur at the point of greatest strain, viz., the femoral neck, pubic rami, and scapulae [15]. These pseudo- fractures in femoral necks often heal but may sometimes progress to displaced fractures, even without trauma [15].…”

“…Due to improper mineralization, pseudofractures of the bones occur at the point of greatest strain, viz., the femoral neck, pubic rami, and scapulae [15]. These pseudo- fractures in femoral necks often heal but may sometimes progress to displaced fractures, even without trauma [15]. Renal osteodystrophy and osteomalacia are common sequelae of end-stage-kidney diseases, and can be complicated by bilateral femoral fractures [2].…”

“…After correcting the serum magnesium levels, calcium and vitamin D can be added to the treatment regimen. As most pseudofractures of the femoral neck do not progress to frank displacement and heal with medical management, prophylactic surgical fixation is not recommended [15]. However, the patient definitely warrants a rigorous follow-up.…”

“…Acute exacerbations of bilateral groin pain with loss of function are the warning signs of displacement, a situation requiring urgent operative intervention. Due to the difficulty in determining the exact timing of these fractures, Chadha et al [15] suggest that the approach should be similar to that used for cases of late-diagnosed femoral fractures. The aim should be to provide a stable fixation.…”