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Takagi Y, Yamada H, Ebara H, Hayashi H, Inatani H, Toyooka K, Ima M, Kitano Y, Ryu Y, Nakanami A, Yahata T, Tsuchiya H. Bilateral simultaneous asymmetric hip fracture without major trauma in an elderly patient: a case report. J Med Case Rep 2022; 16:278. [PMID: 35841109 PMCID: PMC9287992 DOI: 10.1186/s13256-022-03494-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Simultaneous bilateral hip fractures without major trauma in the elderly are rare and usually symmetrical. To the best of our knowledge, only two cases of bilateral simultaneous asymmetric hip fracture in the elderly without major trauma have been reported. CASE PRESENTATION We present the case of a 90-year-old Japanese man with simultaneous bilateral asymmetric hip fractures with trochanteric fracture on the right side and greater trochanteric fracture on the left side. He complained of dyspnea at midnight and was referred to our emergency department. He was admitted to the internal medicine department for bacterial pneumonia treatment. On the 8th day of hospitalization, he was referred to our orthopedic surgery department for hip pain and was found to have fractures of both hips. Computed tomography findings showed that the left femoral neck fracture was an old fracture, while the left greater trochanteric fracture and the right trochanteric fracture were fresh fractures. He was surgically treated through open reduction and internal fixation with an intramedullary nail on the right and hemiarthroplasty on the left in supine position, performed during the same surgical sessions on the 12th day of hospitalization. CONCLUSIONS We report a new form of simultaneous bilateral asymmetric hip fracture in the elderly. The fracture types of the case were femoral trochanteric fracture and greater trochanteric fracture of the femur, which were different from the fracture types in the previously reported two cases. Clinicians should be aware of the possibility of simultaneous bilateral hip fractures, especially in the elderly.
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Affiliation(s)
- Yasutaka Takagi
- Department of Orthopaedic Surgery, Tonami General Hospital, 1-61 Shintomi-cho, Tonami, Toyama, 939-1395, Japan.
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Tonami General Hospital, 1-61 Shintomi-cho, Tonami, Toyama, 939-1395, Japan
| | - Hidehumi Ebara
- Department of Orthopaedic Surgery, Tonami General Hospital, 1-61 Shintomi-cho, Tonami, Toyama, 939-1395, Japan
| | - Hiroyuki Hayashi
- Department of Orthopaedic Surgery, Tonami General Hospital, 1-61 Shintomi-cho, Tonami, Toyama, 939-1395, Japan
| | - Hiroyuki Inatani
- Department of Orthopaedic Surgery, Tonami General Hospital, 1-61 Shintomi-cho, Tonami, Toyama, 939-1395, Japan
| | - Kazu Toyooka
- Department of Orthopaedic Surgery, Tonami General Hospital, 1-61 Shintomi-cho, Tonami, Toyama, 939-1395, Japan
| | - Musashi Ima
- Department of Orthopaedic Surgery, Tonami General Hospital, 1-61 Shintomi-cho, Tonami, Toyama, 939-1395, Japan
| | - Yoshiyuki Kitano
- Department of Orthopaedic Surgery, Tonami General Hospital, 1-61 Shintomi-cho, Tonami, Toyama, 939-1395, Japan
| | - Yasuji Ryu
- Department of Radiology, Tonami General Hospital, 1-61 Shintomi-cho, Tonami, Toyama, 939-1395, Japan
| | - Aki Nakanami
- Department of Rehabilitation Medicine, Tonami General Hospital, 1-61 Shintomi-cho, Tonami, Toyama, 939-1395, Japan
| | - Tetsutaro Yahata
- Department of Rehabilitation Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
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Efremov K, Caterini A, De Maio F, Farsetti P. A simultaneous bilateral asymmetric hip fracture in an elderly patient: A case report and review of the literature. Int J Surg Case Rep 2020; 72:377-380. [PMID: 32563825 PMCID: PMC7306533 DOI: 10.1016/j.ijscr.2020.06.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 12/04/2022] Open
Abstract
Simultaneous bilateral hip fractures in the elderly are rare and usually have a symmetric pattern. Intracapsular fractures on one side and trochanteric on the other are even rarer. They are caused by a spontaneous fracture which causes a fall on the contralateral side. The trochanteric fracture should be operated first to avoid possible complications.
Introduction Simultaneous bilateral hip fractures are usually associated with high energy trauma, seizures, metabolic diseases and bisphosphonates use. They are observed rarely in the elderly population after simple trauma and usually have the same fracture pattern (symmetric). We report a rare case of asymmetric fracture and discuss mechanism of injury and treatment, analyzing the literature. Presentation of case We report a case of an 86-year old woman with a simultaneous bilateral asymmetric hip fracture (trochanteric on the right side and subcapital on the left), occurred after a fall at home. The patient was surgically treated by open reduction and internal fixation with an intramedullary nail on the right and by hemiarthroplasty on the left performed during the same surgical session, with good results. Discussion Simultaneous bilateral hip fractures in the elderly are rare and usually are symmetric. In the majority of the cases these fractures are intracapsular and are treated by hemiarthroplasties. On the contrary, simultaneous bilateral hip fractures with a different pattern, as the described case, are extremely rare. The possible mechanism of injury is a spontaneous fracture on one side, which causes a fall the contralateral side. The surgical treatment may be performed bilaterally, treating first the trochanteric fracture. Conclusion Simultaneous bilateral asymmetric hip fracture are extremely rare and may occur in elderly patient with a specific mechanism of injury. We believe that the trochanteric fracture should be operated first to avoid possible complications.
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Affiliation(s)
- Kristian Efremov
- Department of Orthopaedic Surgery, University of Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| | - Alessandro Caterini
- Department of Orthopaedic Surgery, University of Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| | - Fernando De Maio
- Department of Orthopaedic Surgery, University of Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| | - Pasquale Farsetti
- Department of Orthopaedic Surgery, University of Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
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MacDonald DR, Haddon AE, Barker SL. Simultaneous bilateral hip fractures following a simple fall in an elderly patient: A case report. J Clin Orthop Trauma 2019; 10:972-974. [PMID: 31528078 PMCID: PMC6738497 DOI: 10.1016/j.jcot.2018.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/22/2018] [Accepted: 11/29/2018] [Indexed: 11/25/2022] Open
Abstract
Bilateral fractured necks of femur are rare, particularly in the absence of high energy trauma or metabolic bone disease. We describe a case of an 89 year old man with no history of metabolic bone disease who presented with bilateral neck of femur fractures following a simple fall. Clinicians must be vigilant to ensure that bilateral neck of femur fractures are identified and treated appropriately.
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Affiliation(s)
- David R.W. MacDonald
- Corresponding author. Orthopaedic Department, Aberdeen Royal Infirmary, United Kingdom.
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