Simultaneous Bilateral Femoral Neck Fracture in a Patient with Osteoporosis- A Case Report

摘要

We report a case of bilateral neck of femur fracture in a patient in osteoporotic bone, as a result of a fall from a standing position. A literature review shows all similar fractures are documented to have been associated with high velocity trauma, seizures and/or osteoporosis secondary to steroid use. As far as we are aware this is the first reported case of this fracture pattern in connection with this patient profile and history, which is similar to the vast majority of trauma patients seen. Introduction We report the case of a 79 year old man who suffered simultaneous bilateral femoral neck fractures in osteoporotic bone. Fractures were as a result from a fall from a standing position. Although a very rare occurrence simultaneous bilateral neck fractures are known to be associated with high impact trauma or convulsions, and not with falls from a standing position. Also this is the first reported case of such a fracture pattern in primary osteoporosis. In a review of the English literature we were able to find only 2 other cases of similar fracture pattern associated with osteoporotic bone, however both cases were secondary to steroid induced osteoporosis (1) (6). Case report The patient was a 79year old man who presented with bilateral hip pain after a fall from a standing position. He was independently mobile prior to this episode and co-morbidities included hypertension, hypercholestaemia, gout and osteoporosis. On further questioning he denied any history of treatment with steroids or any excessive alcohol use. He reported a good diet.His vital signs were normal as were his laboratory studies. Complete blood count, Liver function tests and renal function were within normal limits. Radiographs demonstrated bilateral displaced femoral neck fractures (fig. 1) and the patient underwent bilateral hemiarthroplasty (fig 2). The patient did very well post operatively and made good progress with no complications. He was discharged when well.