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Successful treatment for bilateral femoral neck insufficiency fractures: a rare lesion case report and an updated review of the literature.
BMC Musculoskeletal Disorders ( IF 2.3 ) Pub Date : 2020-02-14 , DOI: 10.1186/s12891-020-3107-x
Xu-Yi Tan 1, 2 , Ting Lei 3 , Guan-Bao Wu 2 , Hai-En Luo 2 , Gang Huang 2 , Can-Yu He 2 , Min Lu 1 , Peng-Fei Lei 3
Affiliation  

BACKGROUND The incidence of insufficiency fracture (IF) at femoral neck is low, accounting for about 5% of all insufficiency fractures, and IF at bilateral femoral neck is less common with more occurrence in athlete or serviceman. With the aging of populations, more cases of bilateral femoral neck IF have occurred recently, while the standard clinical treatment still remains lacking due to the complexity of these patients. CASE PRESENTATION A 55-year-old male patient complained pain in his bilateral hip, with no history of trauma, glucocorticoid hormone consumption or radiotherapy, and imaging examination revealed fracture nonunion and shortening in his left femoral neck, and double fracture line on the right femoral neck. The patient received a cementless THA for the left femoral neck fracture and conservative treatment for the right side, followed by Elcatonin injection and oral administration of Carbonate D3 Granules. After 4 months of fellow-up, the patient presented improved functional scorings in bilateral hip joints, with no signs of prothesis infection or loosening. CONCLUSION We present a rare case of bilateral femoral neck IF in a middle-aged male and the treatment is successful. The timely CT and MRI examinations of bilateral hip joints for patients was necessary for orthopedists to select proper therapeutic regimen. In addition, the choice for therapeutic regimen of bilateral femoral IF should not only be based on the professional judgement of orthopedists, but also on the wishes of patients.

中文翻译:

双侧股骨颈功能不全骨折的成功治疗:罕见的病变病例报告和文献更新。

背景技术股骨颈功能不全(IF)的发生率较低,约占所有功能不全骨折的5%,而双侧股骨颈的IF较少见,在运动员或军人中发生率更高。随着人口的老龄化,最近发生了更多的双侧股骨颈IF病例,但是由于这些患者的复杂性,仍然缺乏标准的临床治疗方法。病例介绍一名55岁的男性患者主诉双侧髋关节疼痛,无外伤史,无糖皮质激素消耗或放疗史,影像学检查显示左股骨颈骨折不愈合并缩短,右侧有双骨折线股骨颈。该患者因左股骨颈骨折接受了非骨水泥性THA治疗,对右侧接受了保守治疗,随后进行Elcatonin注射并口服碳酸盐D3颗粒。随访4个月后,患者双侧髋关节功能评分改善,无假体感染或松弛的迹象。结论我们在中年男性中出现了罕见的双侧股骨颈IF病例,治疗成功。对患者来说,及时对双侧髋关节进行CT和MRI检查对于骨科医生选择正确的治疗方案是必要的。此外,双侧股骨中频治疗方案的选择不仅应基于骨科医生的专业判断,还应基于患者的意愿。没有假体感染或松弛的迹象。结论我们在中年男性中出现了罕见的双侧股骨颈IF病例,治疗成功。对患者来说,及时对双侧髋关节进行CT和MRI检查对于骨科医生选择正确的治疗方案是必要的。此外,双侧股骨中频治疗方案的选择不仅应基于骨科医生的专业判断,还应基于患者的意愿。没有假体感染或松弛的迹象。结论我们在中年男性中出现了罕见的双侧股骨颈IF病例,治疗成功。对患者来说,及时对双侧髋关节进行CT和MRI检查对于骨科医生选择正确的治疗方案是必要的。此外,双侧股骨中频治疗方案的选择不仅应基于骨科医生的专业判断,还应基于患者的意愿。
更新日期:2020-02-18
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