Unilateral Femoral Neck Fracture after Epileptic Seizure in Young Patient: A Case Report (original) (raw)
Related papers
Bilateral femoral neck fractures after an epileptic attack: A case report
International journal of surgery case reports, 2015
Bilateral femoral neck fractures can occur due to high- or low-energy trauma, in the presence of various predisposing factors, such as osteoporosis, renal osteodystrophy, hypocalcemic seizures, primary or metastatic tumors, electroconvulsive therapy, epileptic seizures, and hormonal disorders. This report presents a case of bilateral femoral neck fractures that occurred during an epileptic attack in a 24-year-old male with mental retardation. His complaints had started after a grand mal epileptic attack 10 days earlier. Bilateral displaced femoral neck fractures (Garden type 4) were seen in lateral radiographs of both hips. The patient was operated on urgently, with closed reduction, three stainless steel cannulated screws, and internal fixation applied to both hips. At postoperative week 12, solid joining was achieved and active walking with complete loading was started. Bilateral femoral neck fractures can occur following a grand mal epilepsy attack in young patients. The use of a...
Subcapital femoral neck fracture in patients with HIV and osteonecrosis of the femoral head
SA Orthopaedic Journal, 2010
Background: Osteonecrosis of the femoral head generally presents with collapse of the femoral head. A small subset of patients with osteonecrosis of the femoral head, however, have been described in various case reports as presenting with subcapital femoral neck fracture instead. Methods: The three cases presented were gathered retrospectively from the National Joint Registry in Malawi. Results: We present three case reports of patients with HIV who suffered atraumatic subcapital femoral neck fractures in the setting of osteonecrosis of the femoral head. Discussion: Patients with subcapital femoral neck fractures and osteonecrosis of the femoral head in the setting of HIV represent a unique population with diagnostic and management dilemmas that require careful consideration.
2009
Simultaneous bilateral femoral neck fracture following an epileptic seizure attack are rare. Open reduction and internal fixation remains the most used therapeutic option. Arthroplasty, carrying a high risk of dislocation is less often recommended. We report the favourable evolution of a 49-year-old man who benefited from a single stage bilateral total hip arthroplasty operation for his simultaneous bilateral, femoral neck fractures secondary to a generalized seizure. This nonconsensual choice, in this case, was justified on multiple grounds: surgical care delay longer than 48 hours, substantial bone displacement, borderline bone quality, adequate antiepileptic treatment efficacy and tolerance. A ceramic-on-ceramic bearing surfaces couple, a large-diameter head and a cementless implantation design together should be able to provide an acceptable longevity in a young and active patient.
Bilateral simultaneous hip fractures secondary to an epileptic seizure
Saudi medical journal, 2003
A 30-year-old man sustained bilateral simultaneous displaced subcapital fractures of neck of femur during an epileptic tonic-clonic seizure. After admission to the hospital approximately 18 hours later, internal fixation of the fractures with dynamic hip screw was undertaken. Post operatively, he was managed by early motion and weight bearing on the second day. Despite the severity of the fractures and delayed surgery, satisfactory union of the fractures was noted at 6 months when bone densitometry was normal. At 3 years follow up, there was no sign of avascular necrosis of the femoral heads.
High Prevalence of Osteonecrosis of the Femoral Head in HIV-Infected Adults
Annals of Internal Medicine, 2002
Background: Osteonecrosis has been reported to occur occasionally among HIV-infected patients. The diagnosis of symptomatic osteonecrosis of the hip in two of the authors' patients, together with reports from community physicians, raised a concern that the prevalence of osteonecrosis is increasing. Objective: To determine the prevalence of osteonecrosis of the hip in asymptomatic HIV-infected patients and to identify potential risk factors associated with osteonecrosis.
The Incidence and Natural History of Osteonecrosis in HIV-Infected Adults
Clinical Infectious Diseases, 2007
Background. Osteonecrosis is increasingly recognized as a debilitating complication of human immunodeficiency virus (HIV) infection, but the natural history has not been well described. We previously documented a high prevalence (4.4%) of magnetic resonance imaging (MRI)-documented osteonecrosis of the hip in a cohort of 339 asymptomatic HIV-infected patients. The present study was designed to determine the incidence of newly diagnosed osteonecrosis in this cohort and to describe the natural history of osteonecrosis in HIV-infected patients. Methods. Asymptomatic HIV-infected patients with a previous hip MRI negative for osteonecrosis underwent follow-up MRI. Patients with asymptomatic or symptomatic osteonecrosis were enrolled in a natural history study, which included serial MRIs and a physiotherapy follow-up. Results. Two hundred thirty-nine patients underwent a second MRI a median of 23 months after the initial MRI. Osteonecrosis of the femoral head was diagnosed in 3 patients (incidence, 0.65 cases per 100 person-years). During the period of January 1999 through April 2006, symptomatic hip osteonecrosis developed in 13 clinic patients (incidence, 0.26 cases per 100 person-years). Among 22 patients enrolled with symptomatic hip osteonecrosis, 18 had bilateral involvement of the femoral heads, and 7 had osteonecrosis involving other bones. Two (11%) of 18 asymptomatic patients and 13 (59%) of 22 symptomatic patients underwent total hip replacement. The percentage of involvement of the weight-bearing surface of the femoral head and the rate of progression to total hip replacement was significantly greater () in symptomatic patients than in asymptomatic patients. P ! .001 Conclusions. HIV-infected patients are at ∼100-fold greater risk of developing osteonecrosis than the general population. Disease progression is slower in asymptomatic patients than in symptomatic patients. Given the high frequency of total hip replacement in symptomatic patients, studies to assess preventive and treatment strategies are essential.
Turkish Journal of Physical Medicine and Rehabilitation, 2020
Both human immunodeficiency virus (HIV) infection and antiretroviral therapy are related to an increased risk of fracture. As a result of the developments in HIV treatment in recent years, life expectancy in HIV-infected patients has increased. Therefore, HIV-related musculoskeletal problems such as osteoporosis and avascular necrosis are more common currently. There are complex mechanisms in HIV-related osteoporosis. The loss of bone mineral density is particularly distinctive in the first months of the therapy. In this report, we present a 54-year-old woman admitted to our clinic with right thigh pain for three months and diagnosed with a femoral neck stress fracture.
Late-diagnosed bilateral intertrochanteric femur fracture during an epileptic seizure
Turkish Journal of Trauma and Emergency Surgery, 2012
Travma olmadan iki taraflı kalça kırıkları nadirdir, fakat epileptik nöbetler bu tip kırıklara neden olabilir. Bu olgu sunumunda, 82 yaşında, kemik kalitesi kötü olan ve 20 yıllık epilepsi hastası olduğu bilinen bir kadın olgu sunuldu. Hasta yaklaşık 20 yıldır antikonvülzan ilaçlar kullanmaktaydı; bir epilepsi atağı sırasında her iki kalçasında intertrokanterik femur kırığı oluştuğu, fakat tanının 12. gün sonra konulabildiği öğrenildi. Daha erken çekilen bir pelvis ön-arka grafisi erken tanı için yardımcı olabilirdi. Epilepsi hastalarında travma olmaksızın kırıklar olabileceği akılda tutulmalıdır. Anahtar Sözcükler: Epileptik nöbet; kalça kırığı/iki taraflı. Although spontaneous and simultaneous bilateral hip fractures without trauma are seen rarely, epileptic seizures may lead to these fractures. We present an 82-year-old female patient with poor bone quality and a 20-year history of epilepsy. She had been using anticonvulsant drugs for almost 20 years. Following a convulsive epileptic attack, bilateral intertrochanteric femur fractures occurred (causing bilateral hip pain), which was diagnosed on the 12th day. An earlier pelvic anteroposterior roentgenogram would be helpful for early diagnosis. It should not be forgotten that bone fractures may be observed without trauma in epilepsy patients.
Nontraumatic Bilateral Neck of Femur Fracture in Elderly Male Post-seizure Attack
Journal of Orthopedics and Joint Surgery
Among the femoral neck fractures, unilateral injury is the most common presenting feature. 1 In the younger population, it is a result of high energy trauma from road traffic accidents or falls from height. 1,2 In the elderly population, a simple fall results in a fracture of the osteoporotic bone. 3 But a patient sustaining a bilateral neck of femur fracture without any trauma is a rare occurrence. 4 We recently received a 78-year-old male patient who sustained a nontraumatic bilateral neck of femur fracture following a single episode of a generalized tonic-clonic seizure. He is a known chronic obstructive pulmonary disease patient and recovered from COVID pneumonia 6 months back. The patient underwent modular cemented bipolar hemiarthroplasty for both hips as a staged procedure, and the patient was made for walking full weight-bearing from the second postoperative after the second hip was operated.
HIV/AIDS (Auckland, N.Z.), 2018
To examine the presence of HIV in bone tissue of people living with HIV (PLWHIV) with osteonecrosis of femoral head and describe clinical and anatomopathological findings. This is a case series which included 44 PLWHIV with osteonecrosis of femoral head who underwent total hip arthroplasty. Clinical data were obtained through analysis of the patients' medical records. Bone tissue obtained during total hip arthroplasty was retrieved and sent for conventional and immunohistochemical analysis. Monoclonal antibodies were used to mark the p24 (HIV), CD31 (vascular endothelial cells), CD68 (macrophages), and D40 (cells of the lymphatic endothelium) antigens. Dyslipidemia was found in 48% of the patients and lipodystrophy in 31%. Histological analysis showed similar characteristics for the entire sample. Degeneration of joint cartilage was visualized with the presence of fissures and fibrillations, as well as subchondral sclerosis and necrosis of the subchondral cancellous bone tissue....