Non-traumatic, bilateral subcapital femoral fractures postpartum
- PMID: 24445846
- PMCID: PMC3902394
- DOI: 10.1136/bcr-2013-201625
Non-traumatic, bilateral subcapital femoral fractures postpartum
Abstract
A 28-year-old Romanian woman, presented 2 weeks postnatally with pain in her left hip. Plain radiography suggested a left intracapsular, subcapital hip fracture. A CT scan of the pelvis showed diffuse osteopaenia with bilateral subcapital fractures of both femurs. From this imaging and subsequent investigation, a diagnosis of transient osteoporosis of pregnancy was made. The patient was treated with a closed reduction and cannulated screw fixation. Rehabilitative treatment, vitamin D, calcium and bisphosphonate therapy were initiated. She remains under close follow-up from orthopaedic, rheumatological and endocrine teams. Multiple opportunities were missed to identify the source of the patient's pain and inability to weight bear. Early detection and management of this condition is crucial because of the associated morbidity, including debilitating pain, reduced mobility, fractures and avascular necrosis. Cessation of breastfeeding, adequate pain relief, early use of bisphosphonates and rehabilitative treatment are essential.
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References
-
- Kanis J, Melton L, Christiansen C, et al. The diagnosis of osteoporosis. J Bone Miner Res 1994;9:1137–41 - PubMed
-
- Kovacs CS. Calcium and bone metabolism disorders during pregnancy and lactation. Endocrinol Metab Clin North Am 2011;40:795–826 - PubMed
-
- Hosking D. Calcium homeostasis in pregnancy. Clin Endocrinol 2006;45:1–6 - PubMed
-
- Wisser J, Florio I, Neff M, et al. Changes in bone density and metabolism in pregnancy. Acta Obstet Gynecol Scand 2005;84:349–54 - PubMed
-
- Hyppönen E, Power C. Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr 2007;85:860–8 - PubMed
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