Atraumatic Bilateral Transcervical Femoral Neck Fractures in an Elderly Epileptic Patient: A Case Report

Abstract

Introduction: The occurrence of non-traumatic bilateral femoral neck fractures is exceedingly rare, and their manifestation subsequent to an epileptic attack is an uncommon entity with very few cases reported globally.

Case report: We present the positive outcome of a 68-year-old man who underwent staged bilateral constrained total hip arthroplasty following a fracture resulting from a generalized seizure. This unconventional decision was justified based on several factors, including fracture pattern, bone quality, seizure history, and advanced tribology.

Conclusion: Epileptic patients pose a potential high risk for hip dislocation or fracture neck of femur. In such cases, we advocate for primary constrained arthroplasties as a viable and durable option, considering the specific circumstances and challenges associated with these patients.

Keywords: Constrained acetabular liners; atraumatic fractures; bilateral femoral neck fractures; epilepsy and fractures; rare.

Figure 1

Pre-operative X-ray pelvis with both hips.

Figure 2

Immediate post-operative X-ray pelvis with both hips.

Figure 3

X-ray pelvis with both hips at 5 years follow-up.

Figure 4

Functional outcome of the patient at mid-term follow-up.