University department of Orthopaedics and Trauma Surgery, CHU A. Michallon, PO Box 217, 38043 Grenoble Cedex 09, France.
Orthop Traumatol Surg Res. 2009 Nov;95(7):555-7. doi: 10.1016/j.otsr.2009.04.018. Epub 2009 Oct 3.
Simultaneous bilateral femoral neck fracture following an epileptic seizure attack are rare. Open reduction and internal fixation remains the most used therapeutic option. Arthroplasty, carrying a high risk of dislocation is less often recommended. We report the favourable evolution of a 49-year-old man who benefited from a single stage bilateral total hip arthroplasty operation for his simultaneous bilateral, femoral neck fractures secondary to a generalized seizure. This nonconsensual choice, in this case, was justified on multiple grounds: surgical care delay longer than 48 hours, substantial bone displacement, borderline bone quality, adequate antiepileptic treatment efficacy and tolerance. A ceramic-on-ceramic bearing surfaces couple, a large-diameter head and a cementless implantation design together should be able to provide an acceptable longevity in a young and active patient.
癫痫发作后同时发生双侧股骨颈骨折较为罕见。切开复位内固定仍然是最常用的治疗选择。人工关节置换术因脱位风险较高，较少被推荐。我们报告了一位 49 岁男性的良好预后，他因全身性癫痫发作而导致双侧股骨颈骨折，接受了双侧全髋关节置换术一期手术治疗。在这种情况下，这种非共识性的选择是合理的：手术延迟超过 48 小时，骨移位明显，骨质量临界，抗癫痫治疗效果和耐受性良好。陶瓷对陶瓷的轴承表面结合、大头和非骨水泥植入设计应该能够为年轻、活跃的患者提供可接受的长期效果。
