Spontaneous bilateral femur neck fracture secondary to grand mal seizure: A case report

Abstract

BACKGROUND Spontaneous bilateral femur neck fracture is a rare entity in the general population. CASE SUMMARY 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. CONCLUSION A femoral neck fracture may occur in a person with epilepsy presenting with hip pain in the emergency department.

Bilateral Non-traumatic Neglected Femoral Neck Fracture in a Healthy Adolescent: A Case Report and Review of Literature

“…Simultaneous bilateral femur neck fracture in the absence of significant trauma is extremely rare in children. Unlike the elderly population where osteoporosis is a common cause, children usually have an underlying metabolic bone disease rendering them vulnerable to break with trivial trauma ( Table 2 ) [ 3 , 4 , 5 , 7 , 8 , 9 , 10 , 11 , 12 ]. Steinwender et al reported a case of benign osteopetrosis in a 7-year-old boy who was asymptomatic till a bilateral femoral neck fracture occurred [ 3 ].…”

“…Steinwender et al reported a case of benign osteopetrosis in a 7-year-old boy who was asymptomatic till a bilateral femoral neck fracture occurred [ 3 ]. An association has also been reported with seizure disorders secondary to hypocalcemia, autism, cerebral palsy, and electroconvulsive therapy [ 8 , 9 , 10 , 12 ]. The muscle contractions during an epileptic episode can produce excessive rotational stress, thereby producing bilateral neck femur fractures.…”