Babiker Ayman Taj Elsir Mustafa, Yousif Yousif Omer Elgaili, Ahmed Mohammed Mubarak Mohammed, MohammedAhmed Mohammed Alssir, Abd-Elmaged Hozifa Mohammed Ali
Orthopaedics and Traumatology Atbara Teaching Hospital Atbara Sudan.
General Surgery Department Alzaim Alazhari University Khartoum Sudan.
Clin Case Rep. 2024 Sep 3;12(9):e9413. doi: 10.1002/ccr3.9413. eCollection 2024 Sep.
The significance of taking femoral neck stress fractures into account as a possible consequence in sickle cell anemia patients is underscored by this case report. In this high-risk group, early identification, timely diagnosis, and suitable care are crucial for averting major problems and improving results. When sickle cell anemia patients complain with hip or groin discomfort, healthcare practitioners should keep a high index of suspicion for femoral neck stress fractures to assure prompt management and prevent long-term impairment.
Sickle cell disease (SCD) is a prevalent genetic hemoglobinopathy with significant global implications, affecting a substantial portion of the population. Avascular necrosis of the femoral head is a common complication in SCD, leading to severe joint damage and immobility. This case report is of a 20-year-old male who presented with severe hip pain due to a femoral neck stress fracture, which progressed to a complete fracture. This patient had a past medical history of sickle cell anemia and a malunited subtrochanteric fracture that resulted in shortening, external rotation, and a limping gait. Surgical treatment via subtrochanteric osteotomy with fixation using a dynamic hip screw with or without iliac crest bone graft was planned, with a satisfactory reduction and closure of the fracture gap, postoperatively. In cases of sickle cell anemia patients, bone complications such as both osteonecrosis and stress fractures are common. As a healthcare provider, it is important to manage and address these not only through medical interventions, but also through counseling and patient education. Patients must be reminded about the importance of compliance with medical advice to avoid progression or recurrence of complications.
本病例报告强调了将股骨颈应力性骨折视为镰状细胞贫血患者可能出现的后果的重要性。在这个高危群体中，早期识别、及时诊断和适当护理对于避免重大问题和改善预后至关重要。当镰状细胞贫血患者主诉髋部或腹股沟疼痛时，医疗从业者应高度怀疑股骨颈应力性骨折，以确保及时处理并防止长期损伤。
镰状细胞病（SCD）是一种常见的遗传性血红蛋白病，在全球具有重大影响，影响了相当一部分人口。股骨头缺血性坏死是SCD的常见并发症，会导致严重的关节损伤和活动障碍。本病例报告的患者为一名20岁男性，因股骨颈应力性骨折出现严重髋部疼痛，随后发展为完全骨折。该患者既往有镰状细胞贫血病史，还有一处转子下骨折畸形愈合，导致肢体缩短、外旋和跛行步态。计划通过转子下截骨术进行手术治疗，使用动力髋螺钉固定，可选择或不选择髂嵴植骨，术后骨折复位良好，骨折间隙闭合。在镰状细胞贫血患者中，骨坏死和应力性骨折等骨并发症很常见。作为医疗服务提供者，不仅要通过医学干预，还要通过咨询和患者教育来管理和解决这些问题。必须提醒患者遵守医嘱的重要性，以避免并发症的进展或复发。
