Simultaneous Bilateral Fracture of Femoral Neck in Korea: A Case Report

Abstract

Unilateral femoral neck factures are common and their incidence is increasing. However, simultaneous bilateral femoral neck fractures are rare. Although cases of simultaneous bilateral femoral neck fractures have been reported, most were caused by strong muscle contractions during electroconvulsive therapy. Simultaneous bilateral femoral neck fractures caused by a simple fall are an extremely rare injury; therefore, limited literature is available, and no case has been reported in Korea. We report herein a case of simultaneous bilateral femoral neck fractures caused by a simple fall. An 83-year-old woman visited the emergency department with bilateral hip joint pain and gait disturbance, which developed 1 day after a fall. Tenderness and severe limitation in left hip joint range of motion and mild limitation in right hip joint range of motion were observed on a physical examination. A Garden type IV femoral neck fracture in the left hip joint and a Garden type I femoral neck fracture in the right hip joint were observed on plain radiography. She underwent right screw fixation and left bipolar hemiarthroplasty 2 days after admission. The patient could walk using a walker 4 weeks postoperatively. Bone union in the right femoral neck was observed at the 3 month follow-up. No specific findings were observed at the left hip hemiarthroplasty site.

Keywords: Femoral neck fractures; Hemiarthroplasty; Injury mechanism.

Fig. 1. Anteroposterior radiograph of the pelvis shows bilateral femoral neck fractures. Garden type I fracture of femoral neck on the right hip and a Garden type IV fracture of the femoral neck on the left hip.

Fig. 2. Bilateral femoral neck fractures were confirmed by computed tomography.

Fig. 3. Anteroposterior radiograph of the pelvis shows bilateral femoral neck fractures treated surgically (in situ screw fixation of the right hip and bipolar hemiarthroplasty of the left hip).

Fig. 4. Follow-up X-ray shows bone union of the right femoral neck and no specific lesions such as stem loosening or subsidence in the left hip 3 months postoperatively.