Journal of Orthopedics and Joint Surgery

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VOLUME 5 , ISSUE 1 ( January-June, 2023 ) > List of Articles


Nontraumatic Bilateral Neck of Femur Fracture in Elderly Male Post-seizure Attack

Prasanna Chandralingam, Aniish Selvakumar, Anupam Gupta, Pravin Hariharan

Keywords : Aged, Bilateral, Bipolar hemiarthroplasty, Proximal femoral neck fracture, Osteoporosis

Citation Information : Chandralingam P, Selvakumar A, Gupta A, Hariharan P. Nontraumatic Bilateral Neck of Femur Fracture in Elderly Male Post-seizure Attack. 2023; 5 (1):24-26.

DOI: 10.5005/jp-journals-10079-1102

License: CC BY-NC 4.0

Published Online: 03-01-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Among the femoral neck fractures, unilateral injury is the most common presenting feature.1 In the younger population, it is a result of high energy trauma from road traffic accidents or falls from height.1,2 In the elderly population, a simple fall results in a fracture of the osteoporotic bone.3 But a patient sustaining a bilateral neck of femur fracture without any trauma is a rare occurrence.4 We recently received a 78-year-old male patient who sustained a nontraumatic bilateral neck of femur fracture following a single episode of a generalized tonic-clonic seizure. He is a known chronic obstructive pulmonary disease patient and recovered from COVID pneumonia 6 months back. The patient underwent modular cemented bipolar hemiarthroplasty for both hips as a staged procedure, and the patient was made for walking full weight-bearing from the second postoperative after the second hip was operated.

  1. Robinson CM, Court-Brown CM, McQueen MM, et al. Hip fractures in adults younger than 50 years of age. epidemiology and results. Clin Orthop Relat Res 1995;(312):238–246.
  2. Askin SR, Bryan R. Femoral neck fractures in young adults. Clin Orthop Relat Res 1976;(114):259–264.
  3. Protzman RR, Burkhalter WE. Femoral neck fractures in young adults. J Bone Joint Surg Am 1976;58(5):689–695.
  4. Sood A, Rao C, Holloway I. Bilateral femoral neck fractures in an adult male following minimal trauma after a simple mechanical fall: a case report. Cases J 2009;2(1):92. DOI: 10.1186/1757-1626-2-92
  5. Kalaci A, Yannat AN, Sevine TT, et al. Insufficiency fractures of both femoral necks in a young adult caused by osteoporosis: a case report. Arch Orthop Trauma Surg 2008;128(8):865–868. DOI: 10.1007/s00402-008-0647-1
  6. Cody JP, Evans KN, Kluk MW, et al. Occult femoral neck fracture associated with vitamin D deficiency diagnosed by MRI: case report. Mil Med 2012;177:605–608. DOI: 10.7205/milmed-d-11-00321
  7. Fenelon C, Murphy EP, Pomeroy E, et al. Perioperative mortality after cemented or uncemented hemiarthroplasty for displaced femoral neck fractures-a systematic review and meta-analysis. J Arthroplasty 2021;36(2):777–787. DOI: 10.1016/j.arth.2020.08.042
  8. Grimaldi M, Vouaillat H, Tonetti J, et al. Simultaneous bilateral femoral neck fractures secondary to epileptic seizures: treatment by bilateral total hip arthroplasty. Orthop Traumatol Surg Res 2009; 95(7):555–557. DOI: 10.1016/j.otsr.2009.04.018
  9. Rahman MM, Awada A. Bilateral simultaneous hip fractures secondary to an epileptic seizure. Saudi Med 2003; 24(11):1261–1263.
  10. Finelli PF, Cardi JK. Seizure as a cause of fracture. Neurology 1989;39(6):858–860. DOI: 10.1212/wnl.39.6.858
  11. Rath E, Levy O, Liberman N, et al. Bilateral dislocation of the hip during convulsions. J Bone Joint Surg Br 1997; 79(2):304–306. DOI: 10.1302/0301-620x.79b2.7144
  12. Marsh JP, Leiter JRS, MacDonald P. Bilateral femoral neck fractures resulting from a grand mal seizure in an elderly man with Down syndrome. Orthop Rev (Pavia) 2010; 2(1): e10. DOI: 10.4081/or.2010.e10
  13. Sakai S, David D, Shoji H, et al. Bone injuries due to tetany or convulsions during hemodialysis. Clin Orthop Relat Res 1976;(118):118–123.
  14. Taminiau AH, Slooff TJ. Bilateral femoral neck fractures as a complication of myelography. ActaOrthop Scand 1980;51(4):621–624. DOI: 10.3109/17453678008990852
  15. Ribacoba-Montero R, Salas-Puig J. Simultaneous bilateral fractures of the hip following a grand mal seizure. Seizure 1997;6(5):403–404. DOI: 10.1016/s1059-1311(97)80040-4
  16. Mosekilde L, Hansen HH, Christensen MS, et al. Fractional intestinal calcium absorption in epileptics on anticonvulsant therapy: short term effects of 1,25 dihydroxycholecalciferol and 25 hydroxycholecalciferol. Acta Med Scand 1979; 205(5):405–409. DOI: 10.1111/j.0954-6820.1979.tb06073.x
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