Simultaneous bilateral extracapsular proximal femur fractures in the elderly. A case report

Abstract

Simultaneous and bilateral proximal femoral fractures (PFF) are rare and have scarcely been reported in the literature. A case of a bilateral extracapsular PFF is herein presented. Besides, an exhaustive review of the literature was performed, analyzing the information of all previously reported cases. An 81-year-old woman, who suffered a casual fall, was diagnosed with bilateral PFF consisting of both a subtrochanteric and an intertrochanteric fracture. She underwent concurrent intramedullary fixation for both fractures without any relevant complication and started early ambulation. Simultaneous bilateral extracapsular PFF are exceptional, with only 23 cases described in the current literature. In the elderly, they deserve special attention with treatment strategies in between the ones for unilateral hip fractures and those provided to old multiply injured patients. PFF management is not well established. Minimal reaming and careful nailing can be safely performed bilaterally under close monitoring, in order to start an early functional recovery.

Bilateral Intertrochanteric Femur Fractures in a Paraplegic Patient: A Case Report

“…The mechanism of injury for bilateral IT fractures typically involves high-energy trauma or an inciting event such as a seizure or an electrocution [ 4 ]. Moreover, bilateral IT fractures may also present following low-energy mechanisms in patients with underlying locally destructive disease processes such as multiple myeloma and metastatic disease, or concomitant factors like osteoporosis, chronic renal failure, chronic steroid use, electroconvulsive therapy, long-term bisphosphonate use, and certain metabolic disorders [ 5 - 8 ].…”