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      Bilateral simultaneous neck femur fracture following domestic fall in an elderly patient: a rare case report Translated title: Fratura simultânea bilateral do colo do fêmur após queda doméstica em uma paciente idosa: relato de um caso raro

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          Abstract

          Simultaneous bilateral neck femur fracture is a rare entity that has been associated with underlying bone disease, various metabolic diseases, high-energy trauma, and seizure disorders. Its occurrence following minimal trauma is very rare. This article presents the case of a 66-year-old female who sustained bilateral intracapsular fracture neck femur following a slip and fall at home. Single-stage bilateral cemented total hip replacement was done using a direct lateral approach with alternate right and left lateral positions. The authors report a satisfactory outcome, with Harris hip score of 98 at one year, which persisted until her last follow-up at 30 months.

          Resumo

          A fratura simultânea bilateral do colo do fêmur é uma entidade rara que tem sido associada a doenças ósseas, diversas doenças metabólicas, traumas de alta energia e distúrbios convulsivos. Sua ocorrência após trauma mínimo é muito rara. Este artigo apresenta o caso de uma mulher de 66 anos de idade que sofreu fratura intracapsular bilateral do colo do fêmur após um deslize e queda em casa. Uma artroplastia total do quadril, bilateral e cimentada foi feita em um único momento, usando uma abordagem lateral direta, alternando as posições laterais direita e esquerda. Os autores relatam um resultado satisfatório, com Harris Hip Score de 98 após um ano, que persistiu até o último seguimento, aos 30 meses.

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          Bilateral femoral neck fractures in an adult male following minimal trauma after a simple mechanical fall: a case report

          Background Despite being rare there are several reports in the medical literature of bilateral femoral neck fractures in adult patients. They have been reported to have occurred following major trauma, or as a result of primary or secondary bone disease. In this case report we describe for the first time in the literature bilateral femoral neck fractures in a patient following minimal trauma after a simple mechanical fall. Case presentation We describe the case of an 84-year-old gentleman who sustained bilateral intracapsular fractures following a simple mechanical fall. Prompt diagnosis and early surgical intervention resulted in a satisfactory outcome. Conclusion This case highlights that in the elderly, even in the absence of primary and secondary bone disease, bilateral neck of femur fractures can occur following relatively minor trauma. Consequently, the orthopaedic surgeon, emergency physician and general practitioner should be aware of this injury, particularly when managing traumatic injuries in confused patients.
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            Insufficiency fractures of both femoral necks in a young adult caused by osteoporosis: a case report.

            Insufficiency fractures of femoral necks due to osteoporosis of unknown aetiology occurring coincidentally on both sides in young adults, have not been described in English literature so far. A 18-year-old young girl presented with a 3-month history of gradual onset of bilateral thigh pain and progressive inability to walk. At the first look, plain radiographs of both hips showed no gross abnormal findings other than some tips on reduced bone mineral density of the femoral necks. MRI was ordered upon a high suspicion of fracture and T1-weighed MRI showed a linear low signal on both femoral necks. Dual-energy X-ray absorptiometry of the lumbar spine and femoral neck showed low mineral density. She was treated surgically with in-situ internal fixation using cannulated screws. The bilateral thigh pain was resolved and walking started immediately after the treatment. Insufficiency fracture of the femoral neck due to osteoporosis should be kept in mind even in young adults complaining of atypical pain without evidence of unusual activities. We used both the terms of stress fracture and insufficiency (osteoporotic) fracture interchangeably as the mechanism of fractures resemble each other.
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              Management of simultaneous bilateral neck of femur fractures in an elderly patient.

              Simultaneous bilateral neck of femur fracture is rare. There have been few reports of such a condition in the literature. This uncommon pattern of injury has been associated with high-energy trauma, underlying bone disease, and seizure disorders. We describe our experience of such a condition involving an elderly patient with significant cardiovascular comorbidity. The operative approach involved single-stage repair of both the involved joints. Bilateral uncemented hemi-arthroplasty was performed using a single tray of sterile surgical instruments and 2 sterile drapes. We report a satisfactory outcome. Uncemented arthroplasty should be considered in such a case so as to minimize the risk of a possible bone cement implantation syndrome.
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                Author and article information

                Contributors
                Journal
                Rev Bras Ortop
                Rev Bras Ortop
                Revista Brasileira de Ortopedia
                Elsevier
                2255-4971
                14 September 2016
                May-Jun 2017
                14 September 2016
                : 52
                : 3
                : 363-365
                Affiliations
                [0005]Hinduja National Hospital, Department of Orthopaedics, Mumbai, India
                Author notes
                [* ] Corresponding author. vivshetty7777@ 123456gmail.com
                Article
                S2255-4971(16)30085-4
                10.1016/j.rboe.2016.09.002
                5497014
                28702399
                607e5df8-60b0-4b08-a521-54d9054399e9
                © 2016 Sociedade Brasileira de Ortopedia e Traumatologia. Published by Elsevier Editora Ltda.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 15 April 2016
                : 13 June 2016
                Categories
                Case Report

                femoral neck fractures,arthroplasty,replacement,hip,aged,fraturas do colo do fêmur,artroplastia,substituição,quadril,idoso

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