Bilateral simultaneous neck of femur fractures from a single injury in a high-risk patient

Authors

  • Mainak Roy Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India https://orcid.org/0009-0002-3339-2744
  • Deepanjan Das Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
  • Prashant Bhavani Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
  • Samir Dwidmuthe Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
  • Saurabh Sah Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
  • Amey S. Sadar Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20241716

Keywords:

Simultaneous bilateral neck of femur fractures, Metabolic bone abnormality, Bipolar uncemented hemiarthroplasty, Hyponatremic encephalopathy, Multidisciplinary teamwork

Abstract

Simultaneous bilateral neck of femur fractures resulting from a single traumatic event are exceptionally rare. Often these patients have underlying metabolic bone disorders like renal osteodystrophy, osteomalacia, long term steroid intake, osteoporosis, hyperparathyroidism etc. We present a unique case of bilateral neck femur fractures in a patient with no history or objective proof of metabolic bone disease. This case underscores the significance of recognizing atypical presentations and the need for individualized management. A 70-year-old male patient presented with altered sensorium, disorientation, and bilateral hip fractures following a self-fall at home. The absence of metabolic bone abnormalities, along with pre-existing systemic hypertension and coronary artery disease, made this presentation remarkable. Diagnostic workup revealed hyponatremic encephalopathy, further complicating the high-risk surgical status of the patient. A two-stage approach with bipolar uncemented hemiarthroplasty was chosen, and early mobilization was initiated. Remarkably, the patient returned to pre-injury mobility soon after surgery, illustrating the successful outcome. This case highlights the rarity of simultaneous bilateral neck of femur fractures in patients even without metabolic bone disease, emphasizing the need for careful evaluation and customized management. The collaborative efforts of surgeons, physicians, and anesthetists were pivotal in achieving a positive outcome, demonstrating the remarkable potential of multidisciplinary teamwork in challenging medical scenarios. This case serves as a testament to the dedication and expertise of the medical community in the face of extraordinary challenges.

References

Vijayvargiya M, Shetty V, Makwana K, Agarwal N. Bilateral simultaneous neck femur fracture following domestic fall in an elderly patient: a rare case report. Rev Bras Ortop. 2016;52(3):363-5.

Sood A, Rao C, Holloway I. Bilateral femoral neck fractures in an adult male following minimal trauma after a simple mechanical fall: a case report. Cases J. 2009;2(1):92.

Powell HD. Stimultaneous bilateral fractures of the neck of the femur. J Bone Joint Surg Br. 1960;42(B):236-52.

McGoldrick NP, Dodds MK, Green C, Synnott K. Management of Simultaneous Bilateral Neck of Femur Fractures in an Elderly Patient. Geriatr Orthop Surg Rehabil. 2013;4(3):71-3.

Donaldson AJ, Thomson HE, Harper NJ, Kenny NW. Bone cement implantation syndrome. Br J Anaesth. 2009;102(1):12-22.

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Published

2024-06-26

Issue

Section

Case Reports