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Simultaneous Bilateral Femoral Neck Fracture Due to a Tonic-Clonic Seizure and High-Dose Steroid Therapy

Simultaneous bilateral femoral neck fractures (FNFs) are extremely rare and usually associated with an underlying condition affecting the bone quality and mineralization. Convulsions have also been described as a possible cause, mostly as a consequence of epilepsy, hyponatremia, and hypocalcemia. We...

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Autores principales: Diaz Dilernia, Fernando, Estefan, Martin M., Zanotti, Gerardo, Comba, Fernando, Piccaluga, Francisco, Buttaro, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364048/
https://www.ncbi.nlm.nih.gov/pubmed/32695869
http://dx.doi.org/10.1016/j.artd.2020.05.013
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author Diaz Dilernia, Fernando
Estefan, Martin M.
Zanotti, Gerardo
Comba, Fernando
Piccaluga, Francisco
Buttaro, Martin
author_facet Diaz Dilernia, Fernando
Estefan, Martin M.
Zanotti, Gerardo
Comba, Fernando
Piccaluga, Francisco
Buttaro, Martin
author_sort Diaz Dilernia, Fernando
collection PubMed
description Simultaneous bilateral femoral neck fractures (FNFs) are extremely rare and usually associated with an underlying condition affecting the bone quality and mineralization. Convulsions have also been described as a possible cause, mostly as a consequence of epilepsy, hyponatremia, and hypocalcemia. We present a 52-year-old female patient, with bilateral displaced FNFs due to a tonic-clonic seizure and high-dose steroid therapy related to a frontal lobe anaplastic oligodendroglioma brain tumor resection. Two days after admission, bilateral one-stage uncemented total hip arthroplasty (THA) under general anesthesia and through a posterolateral approach was performed using a metal-on-polyethylene bearing surface. Several risk factors can be identified in this unique case, such as the high-dose steroid therapy, the low-demand activity of the patient due to her functional sequelae, and finally, the convulsive episode. Surgeons should be aware of this uncommon injury to ensure early diagnosis and treatment in all patients with a previous history of seizures, chronic steroid use, severe hip pain, and inability to walk. For bone metabolic diseases, preventive measures should be indicated to avoid these complications. Bilateral one-stage uncemented THA represents an effective procedure with a low complication rate allowing early rehabilitation.
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spelling pubmed-73640482020-07-20 Simultaneous Bilateral Femoral Neck Fracture Due to a Tonic-Clonic Seizure and High-Dose Steroid Therapy Diaz Dilernia, Fernando Estefan, Martin M. Zanotti, Gerardo Comba, Fernando Piccaluga, Francisco Buttaro, Martin Arthroplast Today Case Report Simultaneous bilateral femoral neck fractures (FNFs) are extremely rare and usually associated with an underlying condition affecting the bone quality and mineralization. Convulsions have also been described as a possible cause, mostly as a consequence of epilepsy, hyponatremia, and hypocalcemia. We present a 52-year-old female patient, with bilateral displaced FNFs due to a tonic-clonic seizure and high-dose steroid therapy related to a frontal lobe anaplastic oligodendroglioma brain tumor resection. Two days after admission, bilateral one-stage uncemented total hip arthroplasty (THA) under general anesthesia and through a posterolateral approach was performed using a metal-on-polyethylene bearing surface. Several risk factors can be identified in this unique case, such as the high-dose steroid therapy, the low-demand activity of the patient due to her functional sequelae, and finally, the convulsive episode. Surgeons should be aware of this uncommon injury to ensure early diagnosis and treatment in all patients with a previous history of seizures, chronic steroid use, severe hip pain, and inability to walk. For bone metabolic diseases, preventive measures should be indicated to avoid these complications. Bilateral one-stage uncemented THA represents an effective procedure with a low complication rate allowing early rehabilitation. Elsevier 2020-07-14 /pmc/articles/PMC7364048/ /pubmed/32695869 http://dx.doi.org/10.1016/j.artd.2020.05.013 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Diaz Dilernia, Fernando
Estefan, Martin M.
Zanotti, Gerardo
Comba, Fernando
Piccaluga, Francisco
Buttaro, Martin
Simultaneous Bilateral Femoral Neck Fracture Due to a Tonic-Clonic Seizure and High-Dose Steroid Therapy
title Simultaneous Bilateral Femoral Neck Fracture Due to a Tonic-Clonic Seizure and High-Dose Steroid Therapy
title_full Simultaneous Bilateral Femoral Neck Fracture Due to a Tonic-Clonic Seizure and High-Dose Steroid Therapy
title_fullStr Simultaneous Bilateral Femoral Neck Fracture Due to a Tonic-Clonic Seizure and High-Dose Steroid Therapy
title_full_unstemmed Simultaneous Bilateral Femoral Neck Fracture Due to a Tonic-Clonic Seizure and High-Dose Steroid Therapy
title_short Simultaneous Bilateral Femoral Neck Fracture Due to a Tonic-Clonic Seizure and High-Dose Steroid Therapy
title_sort simultaneous bilateral femoral neck fracture due to a tonic-clonic seizure and high-dose steroid therapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364048/
https://www.ncbi.nlm.nih.gov/pubmed/32695869
http://dx.doi.org/10.1016/j.artd.2020.05.013
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