Fragility Fracture of Proximal Femur in a Paraplegic Patient during Passive Joint Movements

INTRODUCTION: In paraplegic patients, chances of fragility fractures increase in view of disuse osteopenia. Theoretically, if a non-optimal force or torque is applied during passive manipulation or physiotherapy, fractures can occur in such patients. We present such a curious case of a pathological fracture of proximal femur wherein the patient heard a click during his daily routine of passive joint mobilization. CASE REPORT: A 31-years-old paraplegic male suffered a subtrochanteric femur fracture as an innocuous injury during his physiotherapy and range of motion (ROM) exercises. He had osteopenia that resulted in this fragility fracture. He was managed with an intramedullary nail, and medical management was done for osteopenia. CONCLUSION: Fragility fractures can occur during passive ROM exercises that require vigilance on the part of the physiotherapists and attendants. Unnecessary forceful movements should be avoided.