Bilateral Subcapital Femoral Neck Fracture in a 28 Year Old Postpartum Woman (original) (raw)

Bilateral subcapital femoral neck fractures secondary to transient osteoporosis during pregnancy: a case report

Journal of orthopaedic surgery (Hong Kong), 2012

Transient osteoporosis during pregnancy is a rare, self-limiting disease. We report on a 36-year-old woman who had bilateral subcapital femoral neck fractures during the 6th month of pregnancy. The diagnosis was made 4 days after delivery, because radiography was declined by the patient for fear of radiation. Fixation was not feasible owing to bone resorption, and 2-stage bipolar hemiarthroplasty was therefore performed. Magnetic resonance imaging is the best non-invasive investigative tool for pregnant women with hip pain. Early detection can prevent complications and resorting to major surgeries.

Bilateral Fracture of Femoral Neck during Pregnancy: A Case of Spontaneous Healing

SM journal of orthopedics, 2017

Fracture of femoral neck is a serious complication of transient hip osteoporosis during pregnancy. A case of atraumatic bilateral femoral neck fracture was reported. The diagnosis was made two months after delivery. The patient refused surgery. Spontaneous healing was noted firstly on the right hip and secondly on the left. Figure 1: Bilateral femoral neck fracture.

Neglected Femoral Neck Fracture Associated with Pregnancy: Case Report

Journal of Academic Research in Medicine

Transient osteoporosis is a self-limiting condition mostly seen in third trimester of pregnancy. MRI is a noninvasive method for the diagnosis of transient osteoporosis in pregnancies with hip and pelvic pain. We present a 28-year-old primipar with a 3-month history of left hip pain one month after delivery. Garden type 3 fracture was detected. The patient underwent intertrochanteric valgus osteotomy and osteosynthesis. Twenty months of follow-up did not reveal any complications such as nonunion or AVN. In the case of hip pain in pregnancy, the diagnosis of transient osteoporosis with MRI can be made early and more serious complications can be avoided. Successful results can be obtained with intertrochanteric valgus osteotomy in the treatment of neglected femur neck fracture in young patients.

Delayed fixation of displaced bilateral, atraumatic, femoral neck fractures in a patient with pregnancy related osteomalacia

Acta orthopaedica Belgica, 2011

We present the case of a woman diagnosed with simultaneous displaced intracapsular femoral neck fractures following the birth of her second child. No traumatic event was identified. Diagnosis was delayed as the cause of her pain was thought to be non-skeletal in origin. Radiological and serological investigations were diagnostic of osteomalacia. Surgical fixation of her fractures was further delayed due to profound hypocalcaemia. Despite the delays, fixation with bilateral dynamic hip screws resulted in union with no evidence of avascular necrosis at 2 years follow-up. We believe this to be the first report of atraumatic bilateral femoral neck fractures and it shows that a good result can be achieved even in the presence of delayed fixation.

Displaced subcapital fracture of the hip in transient osteoporosis of pregnancy

International Orthopaedics, 1997

We describe a case of displaced subcapital fracture of the hip in a woman in the third trimester of her first pregnancy. A pathological fracture occurred in a previously painful hip, and radiographs showed pronounced osteopenia of the femoral head and neck. Closed reduction and internal fixation was carried out 2 weeks after delivery when the osteopenia was still severe. Healing of the fracture followed with recovery of hip movements.

Transient osteoporosis of the hip in pregnancy: the orthopaedic management of bilateral neck of femur fractures in the third trimester

BMJ Case Reports, 2021

Transient osteoporosis of the hip (TOH) is a rare cause of pelvic pain in the third trimester of pregnancy and post partum. Although several cases have been reported in literature, its aetiology is poorly understood. The diagnosis is commonly missed in pregnancy, as the presenting symptoms can be vague, and the risks of radiographic imaging deter clinicians from pursuing investigation. In extreme cases, this pathology presents with neck of femur fractures, with no current guidelines on optimal management. We describe the case of a 24-year-old woman who presented with bilateral neck of femur fractures at 34 weeks gestation. Following an emergency caesarean section, operative management consisted of bilateral closed reduction and internal fixation using dynamic hip screws. Postoperative radiographs demonstrated failure of fixation on the left side, which was revised to a complex primary arthroplasty. This case demonstrates both the diagnostic and management challenges associated with ...

Bilateral femoral neck fractures due to transient osteoporosis of pregnancy: a case report

Cases Journal, 2008

We describe a case of bilateral femoral neck fractures secondary to transient osteoporosis of pregnancy, which were diagnosed after delivery due to the desire to avoid ionising radiation. These fractures were presumed to be secondary to transient osteoporosis of pregnancy and were treated successfully with internal fixation despite delayed presentation. We discuss the role of MRI in the evaluation of hip pain in pregnancy.

Are Two Screws Enough for Fixation of Femoral Neck Fractures? A Case Series and Review of the Literature

The Open Orthopaedics Journal, 2007

There is still a controversy in literature regarding the treatment of subcapital fractures of the hip with internal fixation. Different methods have been tested and studies such as in cadavers mainly prejudge the three cannulated screws application. We present a series of 20 patients in which percutaneous fixation with two parallel cannulated screws under specific technical conditions has led to an uneventful fracture union. No complications were observed at a one year follow-up. Reviewing the literature we found no previous clinical studies on the subject.

Management of femoral neck fractures

Femoral neck fractures are the second most common non-vertebral fragility fracture, and their management is complicated by multiple controversies. This article aims to review the recent literature in an attempt to elucidate current concepts critical to the management of intra-capsular femoral neck fractures. The optimal timing of surgery remains controversial. A recent meta-analysis was able to show that a delay of longer than 24–72 hours resulted in a statistically significant increase in mortality. Internal fixation of undisplaced fractures remains undisputed. In terms of displaced fractures, two well-designed studies have shown significantly higher re-operation rates in patients treated with closed reduction and internal fixation. While there appears to be renewed interest in the use of bi-polar hemiarthroplasty, conflicting evidence has been published with regard to total hip replacement for hip fractures in the elderly, and it may only be indicated in selected subgroups of rela...