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Case Reports
. 2016 Jun 18:3:26-31.
doi: 10.1016/j.tcr.2016.05.005. eCollection 2016 Apr.

Simultaneous bilateral femoral neck fracture in a patient with renal osteodystrophy

Anderson Freitas  1 , Silvio Leite de Macedo Neto  1 , Fabiano Bolpato Loures  1 , Eugênio Dos Santos Neto  1 , Leonardo Coelho de Alencar Barreto  1 , Maurício Siqueira Camilo  1
Affiliations
Case Reports

Simultaneous bilateral femoral neck fracture in a patient with renal osteodystrophy

Anderson Freitas et al. Trauma Case Rep. .

Abstract

We present a unique case of displaced simultaneous bilateral fractures, Garden 3 type, in a 49 year woman treated with non-cemented total hip arthroplasty. The patient showed a Harris hip score of 86 on the right hip and a 81 on the left side on the fourth postoperative year, besides a bilateral Trendelenburg gait, more pronounced on the right side. She needed a cane to walk, and felt pain in the left thigh. The X-ray showed a shortening of 0.9 cm and a left femoral varus. The other arthroplasty components showed good osseointegration and position. We found that the use of the uncemented total hip arthroplasty to treat a simultaneous bilateral fracture in renal osteodystrophy patients has satisfactory results at a four year follow-up. According to the OCEBM Levels of Evidence Working Group, this study is graded as a Level of Evidence IV.

Keywords: Bilateral; Femoral neck fracture; Renal osteodystrophy.

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Figures

Fig. 1
Fig. 1
(A) X-ray images showing poor bone quality and deformity on both hips; (B) computed tomography image of the pelvis clearly demonstrating displaced fractures of both femoral necks.
Fig. 2
Fig. 2
Magnetic resonance image showing necrotic area in both femoral heads.
Fig. 3
Fig. 3
(A) Picture of the femoral heads in position, according to each side. (B) (Upper) Slices of the femoral head to the left; (lower) slices of the femoral head to the right, both featuring extensive areas of necrosis.
Fig. 4
Fig. 4
Histological blade showing a bone trabeculae devoid of periosteum and osteocytes with loss of nuclear basophilia and empty lacuna featuring coagulative necrosis (400 × HE).
Fig. 5
Fig. 5
X-ray image showing the absence of osteolysis, good osseointegration of prosthetic components to the right and acetabular components to the left, with migration of the femoral component and increased left femoral varus.
See this image and copyright information in PMC

References

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