A Rare Case of Bilateral Fracture Neck Femur Treated with Bilateral Distal Loading Stem Total Hip Arthroplasty, in a Single Sitting.

INTRODUCTION

Bilateral intracapsular neck of femur fractures is rare and has been reported in patients with metabolic bone diseases, after electroconvulsive therapy and due to stress fractures. Total hip arthroplasty (THA) is considered as a treatment of choice for old aged patients. Surgery done in a single sitting for such patients helps in early mobilization.

CASE REPORT

A 60-year-old male, known case of epilepsy and chronic renal disease, presented to us with bilateral intracapsular fracture of neck of femur following episode of convulsion. The patient was operated for a distal loading stem THA on both sides in a single sitting. Proximally deficient hip was managed with screw and cerclage looping fixation of greater trochanter on both sides. The post-operative course was uneventful. At 2 weeks, the patient was allowed protected weight-bearing with a walker. At 8 weeks, the patient was doing full weight-bearing, while at 4 months, the patient was carrying out all activities of daily living. Mean Harris hip score was 86 at the end of 6 months.

CONCLUSION

Bilateral long stem distal loading THA can give good clinical and functional outcomes in a case of the bilateral neck of femur fracture with a deficit of proximal femur. The patient can safely be operated for arthroplasty on both sides in a single sitting. Single sitting surgery will help in early mobilization and better functional outcomes.