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Alzahrani MA, Alsabieh M, Alzomor HH, Abdelrahman WA. Simultaneous Bilateral Neck of Femur Fracture After Spiritual Therapy. Cureus 2022; 14:e29469. [PMID: 36299939 PMCID: PMC9587903 DOI: 10.7759/cureus.29469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 11/23/2022] Open
Abstract
Bilateral simultaneous fracture of the neck of the femur is an extremely rare injury; out of the reported cases, 50% are caused by electrical shock. We reported a rare case of simultaneous bilateral femur neck fracture caused by electrical shock as a part of spiritual therapy. The patient underwent bilateral open reduction and internal fixation with cannulated screws. Unfortunately, the fixation failed, and the patient underwent bilateral total hip arthroplasty. The patient was satisfied with the outcome at the final follow-up.
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Ritchie D, Elkbuli A, McKenney M, Renda M. A rare case of low voltage electrical injury leading to bilateral femur fractures and vertebral body fractures: A case report and review of the literature. Int J Surg Case Rep 2021; 84:106066. [PMID: 34119943 PMCID: PMC8196053 DOI: 10.1016/j.ijscr.2021.106066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 05/29/2021] [Accepted: 06/02/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction and importance Low voltage electrical injuries (less than 1000 V) can produce enough tetany to cause fractures, usually of the upper extremities. Simultaneous bilateral fractures of the femoral neck are an extremely rare occurrence. It is even more uncommon for a young healthy male to suffer significant fractures from a low voltage injury. Case presentation A 25-year-old male attempted suicide by filling a bathtub with water and getting into it prior to dropping a blender into the water. He experienced full body convulsions but remained awake throughout the entire event. In the trauma bay his primary complaints were bilateral hip pain and back pain, without neurologic deficit. Radiological studies confirmed bilateral sub-capital femur fractures and thoracic vertebral fractures (compression fractures of T3, T4, T5, T6, T7, T9, and T11). The patient underwent bilateral open reduction and internal fixation (ORIF) of the femurs, while the spine fractures were treated with a thoracic-lumbar-sacral orthosis TLSO brace. Clinical discussion Low voltage electrical injury is more likely to lead to fractures in patients with chronic renal failure and metabolic conditions such as hypocalcemia, osetomalacia, and osteoporosis. Fractures after low voltage electrical injury are extremely uncommon and a high suspicion for these injuries should be maintained because if missed there is a high risk of morbidity and mortality. Conclusion We present a rare case of low voltage electrical injury by 120 V from a domestic US power supply, amplified by water conduction resulting in bilateral femoral neck fractures and vertebral body fractures. Fractures resulting from low voltage electrical injury are usually related to chronic renal failure, and metabolic conditions such as hypocalcemia, osetomalacia, and osteoporosis. Electrical injuries require a thorough assessment including voltage, duration of injury, environment (wet skin or humid environment), and any existing comorbidities. Bilateral femure and vertebral fractures are rare injuries following low-voltage electrical injury.
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Affiliation(s)
- David Ritchie
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA.
| | - Mark McKenney
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA; University of South Florida, Tampa, FL, USA
| | - Michael Renda
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA; University of South Florida, Tampa, FL, USA
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Marttini Abarca J, Carrillo García P, Mora-Fernandez J. Atraumatic bilateral femoral neck fractures in an octogenarian male associated with androgen deprivation therapy: A case report. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2016.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mazzola P, Anzuini A, Picone D, De Filippi F, Dubner L, Bellelli G, Zatti G, Pasinetti GM, Annoni G. Simultaneous bilateral femoral neck fracture and end-stage renal disease in a 76-year-old woman: a case report. Aging Clin Exp Res 2015; 27:555-9. [PMID: 25576255 DOI: 10.1007/s40520-014-0312-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 12/29/2014] [Indexed: 11/30/2022]
Abstract
Hip fracture is a common occurrence in the elderly. Due to the growing demand for the specific care of these patients, we established the Orthogeriatric Unit (OGU) at San Gerardo University Hospital (Italy) in 2007. However, simultaneous bilateral femoral neck fractures among the geriatric population (those aged ≥65 years) are rarely reported in the literature. Reporting the rare case of a frail 76-year-old woman admitted with bilateral hip fracture and end-stage renal disease, we explain the important role played by the OGU and its flexible multidisciplinary approach for providing comprehensive care to patients with multimorbidity and clinical complexity. The team of geriatricians, orthopedic surgeons, anesthesiologists, and, in this case, a nephrologist, helped in the careful planning and timing of the single-step surgical repair, decided the appropriate type of anesthesia, and optimized outcomes. After a prompt evaluation of the patient, the OGU approach can achieve clinical stabilization prior to intervention. Along with a strict follow-up in the postoperative phase, this could result in a significant reduction of complications and mortality rates and an early start to a tailored rehabilitation process. We strongly suggest employing facilities with multidisciplinary teams for cases involving complex patients at short-term high risk for poor clinical outcomes. Indeed, the usual single-specialist model of care is gradually being abandoned worldwide.
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Affiliation(s)
- Paolo Mazzola
- Department of Neurology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY, 10029, USA,
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Abstract
Simultaneous bilateral neck of femur fracture is rare. There have been few reports of such a condition in the literature. This uncommon pattern of injury has been associated with high-energy trauma, underlying bone disease, and seizure disorders. We describe our experience of such a condition involving an elderly patient with significant cardiovascular comorbidity. The operative approach involved single-stage repair of both the involved joints. Bilateral uncemented hemi-arthroplasty was performed using a single tray of sterile surgical instruments and 2 sterile drapes. We report a satisfactory outcome. Uncemented arthroplasty should be considered in such a case so as to minimize the risk of a possible bone cement implantation syndrome.
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Affiliation(s)
- Niall P McGoldrick
- Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
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6
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Yüksel HY, Hapa O, Can M, Kürklü M. Bilateral simultaneous femoral neck fractures secondary to a post-infarct generalized tonic-clonic seizure. A case report. Hip Int 2010; 20:287-91. [PMID: 20544651 DOI: 10.1177/112070001002000226] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2009] [Indexed: 02/04/2023]
Abstract
Bilateral femoral neck fractures are generally associated with high-energy trauma or defects in bone metabolism. We present a patient who had not been subjected to high-energy trauma and in whom there was no bone metabolism disorder.
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Affiliation(s)
- Halil Yalçin Yüksel
- Third Orthopedics and Traumatology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey.
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Hootkani A, Moradi A, Vahedi E. Neglected simultaneous bilateral femoral neck fractures secondary to narcotic drug abuse treated by bilateral one-staged hemiarthroplasty: a case report. J Orthop Surg Res 2010; 5:41. [PMID: 20579374 PMCID: PMC2908061 DOI: 10.1186/1749-799x-5-41] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2010] [Accepted: 06/25/2010] [Indexed: 02/07/2023] Open
Abstract
Simultaneous bilateral femoral neck fractures are extremely rare and associated with various conditions. Up to now Most cases had correlations with major trauma, repetitive minor trauma, seizure, parathyroid or renal dysfunction, anti-epileptic medications, seizure, etc. A 28-year-old addict man referred to us with a 10-year history of narcotic drug abuse and history of 8 months bilateral groin pain. He admitted with displaced bilateral femoral neck fracture. Because of long duration of this condition and osteonecrosis revealed on bone scan, one-staged bilateral hip hemiarthroplasty was done. A good function was noted after surgery to 4-month follow up. Up to now, have not be founded in the literature that a case of bilateral femoral neck fracture associated with narcotic drug abuse. Because of negative effects of opium or smoking on bone tissues, a simple bone pain should aware us about the risk of stress or fatigue fracture.
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Affiliation(s)
- Alireza Hootkani
- Orthopaedics division, Emamreza Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Abstract
A case of femoral neck fracture is reported after electrical shock injury with 300 V direct current in a 41-year old male. He had two small full thickness burns on his left heel, probably the exit wounds. A fracture after electrical shock due to musculoskeletal contractions is a very rare condition. Surgeons caring for patients with electrical injury should be aware of the possibility of skeletal injuries. Without vigilance for these injuries, delay in diagnosis may occur.
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Affiliation(s)
- J. M. L. G. Gehlen
- Department of Surgery, Orbis Medical Center, P.O. Box 5500, 6130 MB Sittard, The Netherlands
| | - A. G. M. Hoofwijk
- Department of Surgery, Orbis Medical Center, P.O. Box 5500, 6130 MB Sittard, The Netherlands
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Abstract
Electrical injury ranges widely from simple shock and mild burns to more extensive superficial injury, internal injury, and mortality. Bony fracture from electrically-induced tetanic muscle contraction is a rare but recognized injury. We report the case of a 14-year-old boy who suffered a minor burn and radius fracture related to an electrical injury involving his electric guitar. An interesting pattern is emerging from available case reports of similar injuries.
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Magu NK, Rohilla R, Gulia A, Singh R. Valgus intertrochanteric osteotomy in neglected simultaneous, bilateral, displaced subcapital femoral neck fractures in an epileptic pregnant woman. Current Orthopaedic Practice 2009; 20:467-469. [DOI: 10.1097/bco.0b013e31819caba1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
The use of immunosuppressive agents to prevent tissue rejection may predispose patients to osteoporosis and fractures. We report a case of bilateral pathological hip fractures in a woman with osteoporosis who had undergone a bipulmonary transplant. To reduce the risk of pathological fractures, patients are given prophylaxes for osteoporosis prior to organ transplantation, but they remain at increased risk of fractures. They should be informed that this side-effect may occur after transplantation.
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Affiliation(s)
- Roberto Seijas
- Department of Orthopedics and Traumatology, Fundacion Garcia Cugat, Hospital Quiron, Barcelona, Spain.
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Abstract
BACKGROUND Hip fractures are a common occurrence among the population today, especially in the elderly. However, the incidence of simultaneous bilateral hip fractures is very rare, and there is a paucity of data in the current literature documenting patients with these hip fractures. METHODS A retrospective case review was performed on all patients treated for hip fractures during the past ten years at our Level I trauma center. RESULTS From 1993 to 2002 there were eight patients who sustained simultaneous bilateral hip fractures. The mean age of the patients was 63 years (range, 34-88 years). The overall survival rate was 63%. In the patients of age group younger than 65, the survival rate was three out of four (75%). In the patients of age group 65 and older, the survival rate was two of four (50%). The length of hospital stay was shorter on average for the younger population, 19 days (range, 17-27 days). The average hospital duration for the older population was 29 days (range, 28-30). CONCLUSION Bilateral hip fractures are usually the result of a high-energy trauma and are associated with other injuries. The morbidity and mortality of this injury are quite high. Patient age, associated injuries, and comorbid conditions should be examined closely because they may influence the patient's recovery.
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Winslow JE, Bozeman WP, Fortner MC, Alson RL. Thoracic Compression Fractures as a Result of Shock From a Conducted Energy Weapon: A Case Report. Ann Emerg Med 2007; 50:584-6. [PMID: 17826867 DOI: 10.1016/j.annemergmed.2007.06.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2007] [Revised: 06/07/2007] [Accepted: 06/11/2007] [Indexed: 11/18/2022]
Abstract
The Taser is an electrical conducted energy weapon used by law enforcement officers throughout the United States and the world. Though generally regarded as safe, conducted energy weapons can produce injuries. In this case report we describe for the first time thoracic spine compression fractures resulting from a conducted energy weapon discharge. Physicians who may care for patients who have been exposed to a conducted energy weapon discharge should be aware of this as a possible complication.
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Affiliation(s)
- James E Winslow
- Department of Emergency Medicine, Wake Forest University Health Sciences, Medical Center Boulevard, Winston-Salem, NC 27157-1089, USA.
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Carpintero P, Abad JA, Urbano D, Jimenez-sánchez C. Simultaneous bilateral fracture of femoral neck in elderly patients: report on two cases. Eur J Orthop Surg Traumatol 2006; 16:172-4. [DOI: 10.1007/s00590-005-0049-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2005] [Accepted: 10/13/2005] [Indexed: 10/24/2022]
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16
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Affiliation(s)
- Ashish Upadhyay
- Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital and Sushruta Trauma Centre, New Delhi, India.
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Negishi H, Kobayashi M, Nishida R, Yamada H, Ariga S, Sasaki F, Fujimoto S. Primary hyperparathyroidism and simultaneous bilateral fracture of the femoral neck during pregnancy. J Trauma 2002; 52:367-9. [PMID: 11835004 DOI: 10.1097/00005373-200202000-00026] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Hiroaki Negishi
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Hokkaido, Japan.
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Abstract
Fratura simultânea bilateral do colo do fêmur é uma patologia rara e geralmente está relacionada a doenças metabólicas ou outras patologias prévias. Esse tipo de fratura pode passar despercebida, piorando o prognóstico desses pacientes. Neste relato, os autores apresentam o caso de um paciente do sexo masculino de 27 anos de idade com fratura simultânea bilateral do colo do fêmur após um episódio de convulsão. Serão discutidos aspectos sobre o mecanismo do trauma, os tipos de tratamento e a dificuldade no diagnóstico nesse tipo de fratura.
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Abstract
The lives of hospitalized patients depend on diagnostic-therapeutic procedures and on the care provided by the health team. It also depends on the quality and availability of factors such as: physical structure and material and human and financial resources. The need to optimize these resources and re-establish patients' health has brought about the Intensive Care Units (ICU), whose design must consider the physical environment and clinical equipment which are indispensable in health care. Aiming at identifying the level of knowledge of health professionals as to technical and operational information in equipment manuals and the perception of the interviewed professionals in relation to the adequacy of the physical and electrical installations of such units, we conducted a descriptive study in an ICU of a public hospital in Salvador, Brazil. The results show that such installations were considered to be unsuitable for the safe development of activities and that most of the health team members did not know the technical or operational specifications in the equipment manuals.
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Affiliation(s)
- C R Madureira
- Serviços de Saúde da Escola de Enfermagem da Universidade Federal da Bahia, Vale do Canela-40110-060-Salvador-Bahia-Brasil
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Abstract
Electrical injuries may cause tetanic contractions capable of producing fractures, even at very low voltages. Patients with localized pain and swelling require radiographs to assess for fracture, even in the absence of other associated trauma.
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Affiliation(s)
- M A Hostetler
- Deparment of Emergency Medicine, Vanderbilt University, Nashville, TN 37232, USA.
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Abstract
Electric injury can cause disruption of cardiac rhythm and breathing, burns, fractures, dislocations, rhabdomyolysis, eye and ear injury, oral and gastrointestinal injury, vascular damage, disseminated intravascular coagulation, peripheral and spinal cord injury, and Reflex Sympathetic Dystrophy. Secondary trauma from falls, fires, flying debris, and inhalation injury can complicate the clinical picture. Diagnostic and treatment considerations for electric injuries are described in this article, which is the second part of a three-part series on electric injuries.
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Affiliation(s)
- R M Fish
- Department of Bioengineering, University of Illinois at Urbana-Champaign, USA
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Affiliation(s)
- W Lederer
- Department of Anaesthesia and Intensive Care Medicine, The Leopold-Franzens-University of Innsbruck, Institute for Emergency Medicine, Austria
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Affiliation(s)
- A J Adams
- West Middlesex University Hospital, Isleworth, UK
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Affiliation(s)
- W A van den Brink
- Department of Neurosurgery, Dijkzigt University Hospital, Rotterdam, The Netherlands
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Abstract
Virtually every part of the body can be injured by electric current. The extent of injury to any given tissue will depend on many factors, including the nature of the tissue and the amount and duration of the electric current. In addition, cardiac and respiratory arrest can be induced by a number of mechanisms with little or no immediate tissue damage. Burns can be caused by the heating of tissue by electric current and by other mechanisms. Secondary trauma may result from falls, explosions, and other events initiated by electric forces. Nervous tissue has the least resistance to current flow and is thus more easily damaged. Part II in this 3-part series will discuss nervous tissue damage first, followed by discussions of damage to tissues of increasingly greater electric resistance. These are blood vessels, muscle, skin, and bone. Less common injuries are discussed last.
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Affiliation(s)
- R Fish
- Gibson Community Hospital, Gibson City, Illinois
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