Bilateral Neck of Femur Fracture in a Child With Underlying Vitamin D Deficiency: A Case Report on Management and 10-Year Follow-Up

Bilateral femoral neck fracture is a rare entity in the pediatric age group. These types of fractures occur mostly due to high-velocity trauma. We report the surgical outcome with approximately 10 years of follow-up in a 10-year-old child presenting with bilateral femoral neck fracture after trivial trauma and underlying nutritional vitamin D deficiency. A 10-year-old female child with bilateral neglected fracture neck of femur was managed with a primary valgus osteotomy done on the left side and closed reduction and screw fixation with fibular grafting done on the right side. Later on, as the right side fracture progressed to non-union, it was converted to valgus osteotomy fixed with an external fixator. The patient had a good functional outcome at 10 years of follow-up with no difficulty in her day-to-day activities. Pathological bilateral fracture neck of femur is rare in children and it is often mismanaged due to a delayed diagnosis. It can have potentially dangerous complications with a grave outcome affecting the rest of the life of the child. Hence it is important to know about such rare presentations so that they can be adequately addressed early on, thereby minimizing the risk of complications like non-union and avascular necrosis.