Najafi Arvin, Azarsina Salman, Hadavi Dorsa, Arkian Rahele, Hatamian Sevak, Chaghamirzayi Pouria
Orthopedic Surgery, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran.
Tehran University of Medical Sciences, Tehran, Iran.
Int J Surg Case Rep. 2024 Nov;124:110332. doi: 10.1016/j.ijscr.2024.110332. Epub 2024 Sep 24.
Simultaneous bilateral femoral neck fractures are rare and challenging, often occurring due to high-energy trauma in younger adults or low-energy trauma compounded by metabolic issues in elderly populations. Neglected cases, particularly in the context of narcotic addiction and limited access to healthcare, present unique management dilemmas. This study aims to contribute insights into the clinical presentation, management strategies, and outcomes of two neglected simultaneous bilateral femoral neck fractures.
We present two cases: a 65-year-old woman and a 45-year-old man, both with a history of narcotic addiction, who presented with neglected simultaneous bilateral femoral neck fractures. Both cases demonstrated significant pain and functional impairment necessitating surgical intervention.
Treatment involved one-stage bilateral hip hemiarthroplasty, which successfully restored function without postoperative complications during follow-up periods of 14 and 16 months. Discussion includes the challenges of diagnosing and managing neglected fractures in vulnerable populations, emphasizing the importance of early recognition and tailored surgical approaches.
Our study suggests the efficacy of one-stage bilateral hip hemiarthroplasty in managing neglected simultaneous bilateral femoral neck fractures due to narcotic addiction. However, variability in outcomes across different surgical techniques highlights the need for individualized treatment plans based on patient-specific factors.
双侧股骨颈同时骨折较为罕见且具有挑战性，常见于年轻成年人的高能创伤或老年人群因代谢问题合并的低能创伤。被忽视的病例，尤其是在存在药物成瘾且获得医疗保健机会有限的情况下，会带来独特的管理难题。本研究旨在深入了解两例被忽视的双侧股骨颈同时骨折的临床表现、管理策略及治疗结果。
我们呈现两例病例：一名65岁女性和一名45岁男性，均有药物成瘾史，因双侧股骨颈同时骨折被忽视前来就诊。两例均表现出严重疼痛和功能障碍，需要手术干预。
治疗采用一期双侧髋关节半关节置换术，在14个月和16个月的随访期内成功恢复功能且无术后并发症。讨论内容包括在脆弱人群中诊断和管理被忽视骨折的挑战，强调早期识别和量身定制手术方法的重要性。
我们的研究表明，一期双侧髋关节半关节置换术在治疗因药物成瘾导致的被忽视双侧股骨颈同时骨折方面具有疗效。然而，不同手术技术的结果存在差异，这凸显了基于患者特定因素制定个性化治疗方案的必要性。
