Simultaneous, Non-traumatic, Bilateral Neck Femur Fractures in Uremic Renal Osteodystrophy: A Report of Three Cases and Literature Review

INTRODUCTION: Bilateral, simultaneous, non-traumatic, pathological femur neck fractures due to renal osteodystrophy (RO) in chronic renal failure cases are uncommon but are increasingly being reported in the literature. Seizure episodes due to uremic encephalopathy could lead to such fractures. CASE REPORTS: We describe three cases of patients with end-stage renal disease and RO, who presented with bilateral, non-traumatic femur neck fractures after episodes of grand mal con-vulsions. We also review the literature for all such similar cases and briefly discuss the path-ophysiology of RO and the management of these pathological fractures. CONCLUSION: Spontaneous, pathological, bilateral neck femur fractures are increasingly being reported in chronic renal failure patients with high morbidity and mortality. These fractures tend to be missed as the patients are generally immobilized and bed ridden due to the renal disease. Early diagnosis with high index of suspicion in patients with hip pain followed by supervised treatment with the involvement of a nephrologist is of uttermost importance.