Garg Sorabh, Singh Jagdeep, Bahadur Raj, Bhaskaran Swarnesh
Department of Orthopaedics, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.
J Orthop Case Rep. 2020 Nov;10(8):19-22. doi: 10.13107/jocr.2020.v10.i08.1840.
Simultaneous bilateral neck of femur fracture is rare. Majority of them are due to low energy incidents with underlying conditions such as malnutrition, chronic renal failure, cystic fibrosis, celiac disease, seizures, steroid abuse, or osteomalacia.
A 68-year-old woman was referred with a 1-year history of bilateral hip pain and a 9-month history of inability to bear weight. She was diagnosed as a displaced bilateral femoral neck fracture secondary to osteomalacia. Due to the long duration of this condition and associated comorbidities, staged bilateral hip hemiarthroplasty was done. A good function was noted after surgery to 4-month follow-up.
Osteomalacia should be suspected in any patient with long-standing bone pain and muscle weakness regardless of age. Numerous options in the form of percutaneous screws, bipolar hemiarthroplasty, and total hip arthroplasty have been mentioned in the literature regarding the management of simultaneous bilateral femoral neck fractures. Staged bipolar hemiarthroplasty was done due to the associated comorbidities.
双侧股骨颈同时骨折较为罕见。其中大多数是由低能量损伤引起的，常伴有营养不良、慢性肾衰竭、囊性纤维化、乳糜泻、癫痫、类固醇滥用或骨软化症等潜在疾病。
一名68岁女性因双侧髋部疼痛1年、无法负重9个月前来就诊。她被诊断为骨软化症继发双侧股骨颈移位骨折。由于病情持续时间长且伴有多种合并症，遂分期进行双侧髋关节半关节置换术。术后至4个月随访时功能良好。
无论年龄大小，任何长期存在骨痛和肌肉无力的患者都应怀疑骨软化症。文献中提到了多种治疗双侧股骨颈同时骨折的方法，如经皮螺钉、双极半关节置换术和全髋关节置换术。由于存在合并症，故采用分期双极半关节置换术。
