Bilateral non-traumatic hip fractures in a heavy smoker COPD patient on inhaled steroids

Abstract

History of COPD with corticosteroid use may be used as a diagnostic tool to identify patients having osteoporosis. Preventive measures can be performed by monitoring high-risk patients with bone mineral densitometry, WHO fracture risk assessment tool (FRAX tool), serum calcium, and vitamin D levels to prevent bone fractures. Treating those patients with the lowest effective dose of corticosteroids should be targeted.

Simultaneous fractures of bilateral femoral and humeral necks after seizure: one-stage total hip arthroplasty using direct anterior approach

“…Bilateral femoral neck fracture is extremely rare, and has been reported after a simple fall or by high-energy related trauma 5,6. However, hypocalcemia-induced seizure,7 hypophosphatasia-induced seizure,8 eclamptic seizure,9 chronic renal failure,10,11 heavy smoking,12 and narcotic drug abuse13 related femoral neck fractures are also reported in the literature.…”

“…The published articles on such cases do not offer detailed information relating to which surgical approach was performed and how many stages were required for that matter. [10][11][12]17 One-stage arthroplasty was usually undertaken with posterolateral 13 or direct lateral approach. 5 Shah et al 4 reported bilateral femoral neck fracture following a generalized seizure.…”

“…Hip arthroplasties for bilateral femoral neck fractures were also reported in the literature. The published articles on such cases do not offer detailed information relating to which surgical approach was performed and how many stages were required for that matter 10–12,17. One-stage arthroplasty was usually undertaken with posterolateral13 or direct lateral approach 5…”

A rare case of a non-traumatic neck of femur fracture in a 17-year-old boy associated with vitamin D deficiency

“…Hip fractures involving no or minimal trauma are uncommon and usually involve an underlying pathology. Causes identified in the literature include epilepsy,10 osteoporosis11 and metabolic bone disease such as osteomalacia,12–14 hyperparathyroidism15 16 and renal osteodystrophy 17…”

Osteoporosis Complicating Some Inborn or Acquired Diseases

“…Significant associated factors are nicotine, reduced mobility and the loss of muscle mass, respiratory acidosis and systemic inflammation with a negative influence of interleukins and pre-existing osteopenia. Also, administration of glucocorticoids, negatively affects the skeleton (Sanel et al 2016). Key factor in accelerating bone loss in COPD is vitamin D deficiency.…”