Simultaneous bilateral femoral neck fractures secondary to epileptic seizures: Treatment by bilateral total hip arthroplasty (original) (raw)
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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...
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.
Unilateral Femoral Neck Fracture after Epileptic Seizure in Young Patient: A Case Report
Open Journal of Orthopedics, 2020
Femoral neck fracture occurring after an epileptic seizure is a rare and under-diagnosed injury. The majority of the reported cases in literature are old patients with osteoporosis. Younger patients present several risk factors of osteopenia and the treatment remains controversial. We present an outcome of a 23 years old patient with unilateral femoral neck fracture occurring during an epileptic seizure and we discuss the associated multiple risk factors of osteopenia and osteonecrosis of the hip. The patient was brought to the emergency department of Teaching Hospital of Kamenge (CHUK) complaining of pain in his left hip that had been progressing for one month after an epileptic seizure. There is a history of HIV infection since birth and epileptic seizures with ongoing treatments for both diseases. Despite the high risk of avascular necrosis, the treatment choice has been influenced by the patient's age and a conservative surgery by internal fixation with Dynamic Hip Screw has been made. Unfortunately, this treatment early resulted in osteonecrosis of the hip since HIV infection itself and the highly active anti-retroviral therapy increase its risk.
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.
Journal of Orthopaedic Case Reports, 2020
Introduction: Bilateral intracapsular neck of femur fractures is rare and has been reported in patients with metabolic bone diseases, after electroconvulsive therapy and due to stress fractures. Total hip arthroplasty (THA) is considered as a treatment of choice for old aged patients. Surgery done in a single sitting for such patients helps in early mobilization. Case Report: A 60-year-old male, known case of epilepsy and chronic renal disease, presented to us with bilateral intracapsular fracture of neck of femur following episode of convulsion. The patient was operated for a distal loading stem THA on both sides in a single sitting. Proximally deficient hip was managed with screw and cerclage looping fixation of greater trochanter on both sides. The post-operative course was uneventful. At 2 weeks, the patient was allowed protected weight-bearing with a walker. At 8 weeks, the patient was doing full weight-bearing, while at 4 months, the patient was carrying out all activities of ...
Seizures Causing Simultaneous Bilateral Neck of Femur Fractures
Case Reports in Orthopedics, 2019
Neck of femur fractures are a ubiquitous injury seen by orthopaedic surgeons. In the elderly, these fractures usually occur after a low energy fall, and are invariably unilateral injuries. Bilateral neck of femur fractures have been reported in patients with metabolic bone disease, after electroconvulsive therapy, and in association with stress fractures. The otherwise healthy index patient in this case report presented most unusually, with simultaneous, bilateral neck of femur fractures that were sustained during a seizure.
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.
Journal of Orthopaedic Case Reports, 2015
Introduction: We report a case of an adolescent sustaining bilateral femoral neck fractures due to a first time epileptic seizure, as a result of expansion of his known syrinx. Case Report: A 19-year-old patient suffering from hypophosphatasia (HPP), Arnold-Chiari malformation, and a ventriculoperitoneal shunt sustained a trivial fall with profound pain and an inability to mobilize. Radiographs demonstrated a right-sided Garden-4 femoral neck and left-sided multi-fragmentary intracapsular/extracapsular fractures. The patient had previously suffered bilateral proximal femoral shaft fractures, treated with intramedullary unlocked nail fixation that was still in situ. Operative treatment with an exchange to Synthes Adolescent Lateral Recon nail was performed on the right with two Recon screws inserted into the femoral head. On the left, the existing Pedinail was preserved with an additional single screw inserted into the femoral head. In addition, 3 months of non-mobilization was requi...
Incidence of five common fracture types in an institutional epileptic population
Injury, 1996
We have reviewed 4521 patient-years and analysed 785 066 seizures to calculate the incidence of five common fractures in an epileptic population. Only 25.0 per cent of these fractures were known to have occurred during a seizure. When age and sex matched against a izormal population: there was an increased incidence of femoral neck fractures (5.2 x ), inter-trochanteric fractures