Delgadillo Blake E, DeFrancisis Jason S, Henwood Luke, Federico Justin R
Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Internal Medicine, Baptist Health, Jacksonville, USA.
Cureus. 2024 Sep 11;16(9):e69203. doi: 10.7759/cureus.69203. eCollection 2024 Sep.
Femoral neck fractures are a common complication of falls, particularly in the osteoporotic elderly female population. This case highlights the significance of properly radiologically evaluating elderly patients with falls. A 68-year-old White female with paroxysmal atrial fibrillation on anticoagulation, nicotine use disorder, chronic hyponatremia, hypertension, and hyperlipidemia presented to the emergency department (ED) in considerable pain four days after a previously diagnosed left pubic symphysis fracture. Repeat imaging (X-ray and computed tomography (CT)) was significant for a left femoral neck fracture concurrent with the aforementioned pelvic fracture. Within 48 hours of admission, the patient underwent a hemiarthroplasty of the left hip. The postoperative course was unremarkable, except for immensely decreased pain and a remarkable ability to ambulate, and on postoperative day three, the patient was discharged. In patients with an overall high risk of hip fracture, CT imaging should be considered after X-ray in an effort to eliminate the frequency of undiagnosed fractures. It is essential to thoroughly evaluate the entire film, even after one fracture is found. This is crucial to a patient's overall well-being and can contribute to many unwanted phenomena.
股骨颈骨折是跌倒的常见并发症,尤其在骨质疏松的老年女性人群中。本病例强调了对跌倒的老年患者进行适当的放射学评估的重要性。一名68岁的白人女性,患有阵发性心房颤动且正在接受抗凝治疗,有尼古丁使用障碍、慢性低钠血症、高血压和高脂血症,在先前诊断为左耻骨联合骨折四天后,因剧痛就诊于急诊科。再次影像学检查(X线和计算机断层扫描(CT))显示左股骨颈骨折与上述骨盆骨折并存。入院后48小时内,患者接受了左髋关节半关节置换术。术后过程顺利,疼痛大幅减轻,行走能力显著提高,术后第三天患者出院。在髋部骨折总体风险较高的患者中,应在X线检查后考虑进行CT成像,以减少未诊断骨折的发生率。即使发现一处骨折,也必须全面评估整个影像。这对患者的整体健康至关重要,否则可能导致许多不良情况。