• femoral neck stress fracture
• insufficiency fracture
• osteoporosis

• Aged
• Male
• Humans
• Femur Neck/diagnostic imaging
• Fractures, Stress/diagnostic imaging
• Femoral Neck Fractures/diagnostic imaging
• Femoral Neck Fractures/surgery
• Hip Fractures
• Pain

• Department of Health of Zhejiang Province

• Femoral neck
• Femoral neck stress fracture
• Hip
• Stress fracture

• basicervical
• bone morphometry
• femoral neck fracture
• osteomalacia
• pain
• vitamin D deficiency

Spontaneous bilateral femur neck fracture is a rare entity in the general population.

A 17-year-old immobile, developmentally delayed male with the sequelae of cerebral palsy fractured both femoral necks during a grand mal epileptic seizure. He had been treated with valproic acid as an antiseizure medication for about 10 years; otherwise, he had no history of drug use. The laboratory analysis was normal except a marked vitamin D deficiency. Closed reduction and osteosynthesis with percutaneous cannulated screws were performed. Solid union was observed at 6 mo, and rapid postoperative rehabilitation was started.

A femoral neck fracture may occur in a person with epilepsy presenting with hip pain in the emergency department.

• Grand mal seizure
• Bilateral femur neck fracture
• Antiepileptic drugs
• Immobile patient
• Valproic acid use
• Spontan fracture
• Case report

We report, to the best of our knowledge, the first case of simultaneous insufficiency fracture of the bilateral femoral neck in an older patient taking bisphosphonate. Femoral neck fractures frequently occur in older individuals because of traumatic incidents, such as a fall. A 74-year-old woman with osteoporosis was taking raloxifene hydrochloride and bisphosphonate for approximately 5 and 3 years, respectively. Despite no history of falls or any other traumatic incidence, the patient reported cooccurrence of pain on both sides of the hip. Imaging revealed bilateral femoral neck fractures. Bipolar hemiarthroplasty and internal fixation were conducted on the right and left hips, respectively. At 6 months postoperatively, the patient reported gradual disappearance of left hip pain, and a radiograph revealed that the fracture had healed. Overall, clinical and histological findings suggested an atypical fracture, thereby proving that this type of fracture can occur in areas other than the femoral shaft.

• Femoral neck stress fractures
• Hip fractures
• Internal fixation

• Bilateral
• Case report
• Femoral neck fracture
• Insufficiency fractures

• Adolescent
• Aged
• Aged, 80 and over
• Arthroplasty, Replacement, Hip/methods
• Bone Screws
• Calcitonin/administration & dosage
• Calcitonin/analogs & derivatives
• Calcium-Regulating Hormones and Agents/administration & dosage
• Cholecalciferol/administration & dosage
• Conservative Treatment
• Female
• Femoral Neck Fractures/diagnostic imaging
• Femoral Neck Fractures/drug therapy
• Femoral Neck Fractures/surgery
• Femur Neck/surgery
• Follow-Up Studies
• Fracture Fixation, Internal/methods
• Fractures, Stress/diagnostic imaging
• Fractures, Stress/drug therapy
• Fractures, Stress/surgery
• Fractures, Ununited/diagnostic imaging
• Fractures, Ununited/drug therapy
• Fractures, Ununited/surgery
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Tomography, X-Ray Computed
• Treatment Outcome
• Young Adult

• No. 2018JJ3844 Natural Science Foundation of Hunan Province, China
• No. B2019188 Scientific Research Project of Health and Family Planning Commission of Hunan Province, China
• No. 2017Q07 the Youth Science Foundation of Xiangya Hospital Central South University
• No. 223551 the Postdoctoral Research Program of Xiangya Hospital Central South University

•

Physicians should take spontaneous femoral neck occult fracture into consideration if they report groin pain or difficulty in walking, even when findings from plain X-ray are normal.

Bilateral stress fracture of the femoral neck is very rarely seen in healthy young patients who are neither athletes nor military recruits.

The present report describes a 51-year-old male patient, not an athlete and with no previous history of disease, who developed bilateral stress fracture of the femoral neck without displacement.

Simultaneous bilateral femoral neck fracture is a rare injury. In the present case, two factors predisposed to bilateral occult fracture of the femoral neck. The first was osteoporosis due to the patient’s smoking and alcohol abuse. The second was vitamin D deficiency osteomalacia associated with inadequate sun exposure.

All patients who present with spontaneous hip pain should be evaluated for osteoporosis and osteomalacia and assessed for underlying occult fracture if they report groin pain or difficulty in walking, even when findings from plain X-ray are normal, to improve prognosis in this rare and serious condition.

• Femoral neck fracture
• Occult fracture
• Osteomalacia
• Osteoporosis

• Aged
• Arthroplasty
• Femoral neck fractures
• Hip
• Replacement

We report a case of bilateral fracturing of the femoral neck in a patient with renal osteodystrophy who was treated by means of osteosynthesis. In this type of patient, there is a need to remain watchful for the possibility of occurrences of spontaneous fracturing of the femoral neck, even if the initial radiographic examination is normal.

• Fracture fixation
• Fractures of the femoral neck
• Renal osteodystrophy

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.