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Simultaneous bilateral femoral neck fracture and end-stage renal disease in a 76-year-old woman: a case report

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Abstract

Hip fracture is a common occurrence in the elderly. Due to the growing demand for the specific care of these patients, we established the Orthogeriatric Unit (OGU) at San Gerardo University Hospital (Italy) in 2007. However, simultaneous bilateral femoral neck fractures among the geriatric population (those aged ≥65 years) are rarely reported in the literature. Reporting the rare case of a frail 76-year-old woman admitted with bilateral hip fracture and end-stage renal disease, we explain the important role played by the OGU and its flexible multidisciplinary approach for providing comprehensive care to patients with multimorbidity and clinical complexity. The team of geriatricians, orthopedic surgeons, anesthesiologists, and, in this case, a nephrologist, helped in the careful planning and timing of the single-step surgical repair, decided the appropriate type of anesthesia, and optimized outcomes. After a prompt evaluation of the patient, the OGU approach can achieve clinical stabilization prior to intervention. Along with a strict follow-up in the postoperative phase, this could result in a significant reduction of complications and mortality rates and an early start to a tailored rehabilitation process. We strongly suggest employing facilities with multidisciplinary teams for cases involving complex patients at short-term high risk for poor clinical outcomes. Indeed, the usual single-specialist model of care is gradually being abandoned worldwide.

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References

  1. Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7(5):407–413

    Article  CAS  PubMed  Google Scholar 

  2. Mazzola P, De Filippi F, Castoldi G, Galetti P, Zatti G, Annoni G (2011) A comparison between two co-managed geriatric programmes for hip fractured elderly patients. Aging Clin Exp Res 23(5–6):431–436

    Article  PubMed  Google Scholar 

  3. Bellelli G, Mazzola P, Corsi M et al (2012) The combined effect of ADL impairment and delay in time from fracture to surgery on 12-month mortality: an observational study in orthogeriatric patients. J Am Med Dir Assoc 13(7):664.e9–664.e14

    Article  Google Scholar 

  4. Katz S, Downs TD, Cash HR, Grotz RC (1970) Progress in development of the index of ADL. Gerontologist Spring 10(1):20–30

    Article  CAS  Google Scholar 

  5. Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198

    Article  CAS  PubMed  Google Scholar 

  6. Marsh JP, Leiter JR, Macdonald P (2010) Bilateral femoral neck fractures resulting from a grand mal seizure in an elderly man with Down syndrome. Orthop Rev (Pavia). 2(1):e10

    Article  PubMed Central  PubMed  Google Scholar 

  7. McGoldrick NP, Dodds MK, Green C, Synnott K (2013) Management of simultaneous bilateral neck of femur fractures in an elderly patient. Geriatr Orthop Surg Rehabil 4(3):71–73

    Article  PubMed Central  PubMed  Google Scholar 

  8. Brennan SA, O’Neill CJ, Tarazi M, Moran R (2013) Bilateral neck of femur fractures secondary to seizure. Pract Neurol 13(6):420–421

    Article  PubMed  Google Scholar 

  9. Yüksel HY, Hapa O, Can M, Kürklü M (2010) Bilateral simultaneous femoral neck fractures secondary to a post-infarct generalized tonic-clonic seizure. A case report. Hip Int 20(2):287–291

    PubMed  Google Scholar 

  10. Haronian E, Silver JW, Mesa J (2002) Simultaneous bilateral femoral neck fracture and greater tuberosity shoulder fracture resulting from seizure. Orthopedics 25(7):757–758

    PubMed  Google Scholar 

  11. Carter T, Nutt J, Simons A (2014) Bilateral femoral neck insufficiency fractures secondary to vitamin D deficiency and concurrent corticosteroid use–a case report. Arch Osteoporos 9(1):172

    Article  CAS  PubMed  Google Scholar 

  12. Gerster JC, Charhon SA, Jaeger P et al (1983) Bilateral fractures of femoral neck in patients with moderate renal failure receiving fluoride for spinal osteoporosis. Br Med J (Clin Res Ed) 287(6394):723–725

    Article  CAS  Google Scholar 

  13. Austin JC, Chrissos M (2005) Displaced bilateral femoral neck fractures in a woman with a history of oral steroid use. Orthopedics 28(8):795–797

    PubMed  Google Scholar 

  14. Rubinstein A, Liron M, Bodner G, Gefel A (1982) Bilateral femoral neck fractures as a result of coeliac disease. Postgrad Med J 58(675):61–62

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Pearce DH, White LM, Bell RS (2001) Musculoskeletal images. Bilateral insufficiency fracture of the femoral neck. Can J Surg 44(1):11–12

    CAS  PubMed Central  PubMed  Google Scholar 

  16. Cakmak S, Mahirogullari M, Kurklu M, Yildiz C (2012) Bilateral femoral neck stress fracture following bilateral total knee arthroplasty: a case report. Acta Orthop Traumatol Turc 46(4):312–315

    Article  PubMed  Google Scholar 

  17. Sood A, Rao C, Holloway I (2009) Bilateral femoral neck fractures in an adult male following minimal trauma after a simple mechanical fall: a case report. Cases J 2(1):92

    Article  PubMed Central  PubMed  Google Scholar 

  18. Siddique K, Athanatos L, Housden P (2011) Spontaneous bilateral neck of femur fractures and shoulder dislocation. BMJ Case Rep. doi:10.1136/bcr.05.2010.3034

    PubMed Central  PubMed  Google Scholar 

  19. Grimaldi M, Vouaillat H, Tonetti J, Merloz P (2009) Simultaneous bilateral femoral neck fractures secondary to epileptic seizures: treatment by bilateral total hip arthroplasty. Orthop Traumatol Surg Res 95(7):555–557

    Article  CAS  PubMed  Google Scholar 

  20. Pappademos PC, Hamilton WG (2009) Bilateral displaced femoral neck fractures after myoclonic seizure treated with bilateral total hip arthroplasties. Am J Orthop (Belle Mead NJ) 38(2):88–89

    Google Scholar 

  21. Vanderhooft E, Swiontkowski M (1994) Bilateral femoral neck fractures following a grand mal seizure. Ann Emerg Med 24(6):1188–1191

    Article  CAS  PubMed  Google Scholar 

  22. Rahman MM, Awada A (2003) Bilateral simultaneous hip fractures secondary to an epileptic seizure. Saudi Med J 24(11):1261–1263

    PubMed  Google Scholar 

  23. Powell HD (1960) Simultaneous bilateral fractures of the neck of the femur. J Bone Joint Surg Br 42-B:236–252

    CAS  PubMed  Google Scholar 

  24. Schroder J, Marti RK (2001) Simultaneous bilateral femoral neck fractures: case report. Swiss Surg 7(5):222–224

    Article  CAS  PubMed  Google Scholar 

  25. Chadha M, Balain B, Maini L, Dhal A (2001) Spontaneous bilateral displaced femoral neck fractures in nutritional osteomalacia—a case report. Acta Orthop Scand 72(1):94–96

    Article  CAS  PubMed  Google Scholar 

  26. Yassin A, Jawad I, Coomber R, Gonzalez-Castro A (2014) Non-traumatic, bilateral subcapital femoral fractures postpartum. BMJ Case Rep. doi:10.1136/bcr-2013-201625

    PubMed  Google Scholar 

  27. Tompkins GS, Henderson RC, Peterson HD (1990) Bilateral simultaneous fractures of the femoral neck: case report. J Trauma 30(11):1415–1416

    Article  CAS  PubMed  Google Scholar 

  28. Shaheen MA, Sabet NA (1984) Bilateral simultaneous fracture of the femoral neck following electrical shock. Injury 16(1):13–14

    Article  CAS  PubMed  Google Scholar 

  29. Slater RR Jr, Peterson HD (1990) Bilateral femoral neck fractures after electrical injury: a case report and literature review. J Burn Care Rehabil 11(3):240–243

    Article  PubMed  Google Scholar 

  30. Taylor LJ, Grant SC (1985) Bilateral fracture of the femoral neck during a hypocalcaemic convulsion. A case report. J Bone Joint Surg Br 67(4):536–537

    CAS  PubMed  Google Scholar 

  31. Suh KT, Kang DJ, Lee JS (2006) Bilateral intertrochanteric fractures after surgical treatment of bilateral femoral neck fractures secondary to hypocalcemic convulsions with chronic renal failure: a case report and review of the literature. Arch Orthop Trauma Surg 126(2):123–126

    Article  PubMed  Google Scholar 

  32. Moorthi RN, Moe SM (2013) Recent advances in the noninvasive diagnosis of renal osteodystrophy. Kidney Int 84(5):886–894

    Article  CAS  PubMed  Google Scholar 

  33. Coco M, Rush H (2000) Increased incidence of hip fractures in dialysis patients with low serum parathyroid hormone. Am J Kidney Dis 36(6):1115–1121

    Article  CAS  PubMed  Google Scholar 

  34. Klein DM, Tornetta P, 3rd, Barbera C, Neuman D (1998) Operative treatment of hip fractures in patients with renal failure. Clin Orthop Relat Res (350):174–178

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Conflict of interest

On behalf of all the authors, the corresponding author states that the present manuscript was unfunded, and that there is no conflict of interest to disclose. A signed informed consent form was obtained by the patient for the anonymous treatment and publication of her medical information. The form is archived at San Gerardo University Hospital in Monza, Italy.

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Authors and Affiliations

  1. Department of Neurology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY, 10029, USA

    Paolo Mazzola, Lauren Dubner & Giulio M. Pasinetti

  2. Department of Health Sciences, Geriatric Clinic, San Gerardo University Hospital, University of Milano-Bicocca, Via Pergolesi 33, Floor 7 C, 20900, Monza, MB, Italy

    Paolo Mazzola, Alessandra Anzuini, Domenico Picone, Giuseppe Bellelli & Giorgio Annoni

  3. Geriatric Rehabilitation and Sub-acute Care Unit, Department of Medicine, Regional Hospital of Valtellina and Valchiavenna, 23100, Sondrio, SO, Italy

    Francesco De Filippi

  4. Geriatric Research Group, GRG, 25121, Brescia, Italy

    Giuseppe Bellelli

  5. Department of Surgery, Orthopaedic Clinic, San Gerardo University Hospital, University of Milano-Bicocca, 20900, Monza, MB, Italy

    Giovanni Zatti

  6. Geriatric Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, New York, NY, 10468, USA

    Giulio M. Pasinetti

  7. Clinical Neurosciences research area, NeuroMI, Milan Center for Neuroscience, 20126, Milan, MI, Italy

    Paolo Mazzola, Giuseppe Bellelli & Giorgio Annoni

Authors
  1. Paolo Mazzola
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  2. Alessandra Anzuini
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  3. Domenico Picone
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  4. Francesco De Filippi
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  5. Lauren Dubner
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  6. Giuseppe Bellelli
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  7. Giovanni Zatti
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  8. Giulio M. Pasinetti
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  9. Giorgio Annoni
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Corresponding authors

Correspondence to Paolo Mazzola or Giorgio Annoni.

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Mazzola, P., Anzuini, A., Picone, D. et al. Simultaneous bilateral femoral neck fracture and end-stage renal disease in a 76-year-old woman: a case report. Aging Clin Exp Res 27, 555–559 (2015). https://doi.org/10.1007/s40520-014-0312-1

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  • DOI: https://doi.org/10.1007/s40520-014-0312-1

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