Spontaneous bilateral femoral neck fractures in a young male adult: a case report and literature review

Arisumi, Shinkichi; Mawatari, Taro; Ikemura, Satoshi; Matsui, Gen; Iguchi, Takahiro; Mitsuyasu, Hiromichi

doi:10.1186/s12891-019-2857-9

Cited by 13 publications

(21 citation statements)

References 23 publications

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“…In one previous case report, a 33-year-old man was reported to have bilateral femoral neck (hip) fracture with low T-scores in the lumbar spine and femoral neck. The authors discussed that the fracture and low T-score occurred because the man had not been exposed to sunlight for 3 years [31]. In other words, this report shows that even a healthy young man could have bone loss and fracture if he had no exposure to sunlight for a long period.…”

Section: Discussionmentioning

confidence: 92%

Physical Activity, Sunshine Duration, and Osteoporotic Fractures: A Nested Case-Control Study

Min

Yoo

Kwon

et al. 2022

JPM

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This study examined the associations between the occurrence of osteoporotic fractures in detailed sites and combined physical activity (PA) and sunshine duration (SD). Data from the Korean National Health Insurance Service—National Health Screening Cohort for 7-year periods and from the Korea Meteorological Administration were used. Osteoporotic fractures (n = 12,103), including vertebral fractures, hip fractures, and distal radius fractures, and matched controls (n = 24,206) were selected in 1:2 ratios by age, sex, income, and region of residence. PA was classified as moderate- to high-intensity PA (High PA) and low-intensity PA (Low PA). SD was classified as Short SD (<6.1 h) and Long SD (≥6.1 h). Conditional logistic regression was used to calculate the odds ratios (ORs) with 95%-confidence intervals (CIs) of the combined PA and SD groups for the occurrence of each osteoporotic fracture. Compared to ‘Low PA + Short SD’, the adjusted ORs (95% CIs) for vertebral fracture in ‘High PA + Short SD’ and ‘High PA + Long SD’ were 0.83 (0.76–0.91) and 0.84 (0.77–0.92), respectively. Hip/distal radius fractures were not associated with the combined PA and SD group. We suggest that a higher intensity of PA is inversely associated with the risk of vertebral fracture.

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Section: Discussionmentioning

confidence: 92%

Physical Activity, Sunshine Duration, and Osteoporotic Fractures: A Nested Case-Control Study

Min

Yoo

Kwon

et al. 2022

JPM

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“…Powell in 1960 was focused on femoral neck fractures occurring mainly through contractions following electroconvulsive therapy. Hormone activity [ 24 , 41 ], metabolic diseases affecting the bones, and deficiencies in vitamin D or calcium [ 20 , 42 ], were not investigated. Since the 1960s, medical research has evolved tremendously within all branches, including in orthopedics, traumatology, metabolic diseases, and others.…”

Section: Discussionmentioning

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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“…We presented this rare case of a 31-year-old healthy male patient with simultaneous atraumatic bilateral neck of femur fractures, and this type of injury in this age group was reported in the literature in few case reports and was the result of high-energy trauma, seizure activity [3,4,7], electrical shock [9], or altered bone metabolism [5,6,8].…”

Section: Discussionmentioning

confidence: 99%

“…Simultaneous atraumatic bilateral femoral neck fractures in young adults are considered very rare injuries. Few cases were reported in literature in this age group [3][4][5][6][7][8][9]. These fractures are associated with complications such as avascular necrosis and nonunion [10,11].…”

Section: Introductionmentioning

confidence: 99%

Simultaneous Bilateral Neck of Femur Fracture in a Young Adult with Underlying Metabolic Disturbances

Alkaramani

Salameh

Adam

et al. 2020

Case Reports in Orthopedics

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Introduction. Simultaneous bilateral fractures of the femoral neck are considered very rare injuries. Few cases were reported in the literature. Most cases were reported in elderly patients with underlying bone pathology. Case Report. We report a case of a 31-year-old male patient who presented to the emergency department with bilateral hip pain and inability to bear weight after a sudden loss of consciousness and fall while running on a treadmill. The patient had a recent history of anabolic steroids, growth hormone, and other supplements used for bodybuilding. Radiological studies confirmed bilateral neck of femur fracture. Laboratory investigations revealed pan-pituitary axis insufficiency and mild vitamin D deficiency, and his EEG suggested a seizure attack. The patient was treated with three 6.5 mm cannulated cancellous screws on one side and a sliding hip screw on the other side and was followed with strict physical therapy and rehabilitation plan. 6 months from the injury, a radiographic bilateral union achieved with the patient back to his normal daily activity and noncontact sports. Conclusion. We report this rare case of bilateral neck of femur fracture in a young adult after a generalized seizure attack with underlying metabolic disturbances. Ruling out other biological underlying etiologies, early diagnosis and early fracture anatomic reduction and fixation are crucial to decrease potential complications such as avascular necrosis and fracture nonunion.

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Spontaneous bilateral femoral neck fractures in a young male adult: a case report and literature review

Cited by 13 publications

References 23 publications

Physical Activity, Sunshine Duration, and Osteoporotic Fractures: A Nested Case-Control Study

Physical Activity, Sunshine Duration, and Osteoporotic Fractures: A Nested Case-Control Study

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

Simultaneous Bilateral Neck of Femur Fracture in a Young Adult with Underlying Metabolic Disturbances

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