[Spontaneous bilateral fractures of the femoral neck. Etiology-frequency-diagnosis-therapy].
BACKGROUND
Medial and pertrochanteric fractures of the femoral neck occur commonly in patients with bone weakness due to osteoporosis or osteomalacia. Combined bilateral hip injury is much rarer.


METHODS
The case of a Turkish woman with bilateral fractures of the femoral neck due to secondary hyperparathyroidism caused by nutritional vitamin-D 3 deficiency is described and compared to 80 cases of bilateral hip fractures mentioned in English and German literature.


RESULTS
Until the late 1950's the most common reason for simultaneous bilateral femoral neck fractures was convulsive therapy of psychosis by drug or electroshock without use of relaxants, followed by seizures of other origin. Primary and secondary bone diseases are the most common reason for two-fold spontaneous bilateral fractures of the femoral neck.


CONCLUSIONS
At the time of first pain radiological findings are often normal. In this situation MRI, isotope bone scanning or additional chemical diagnostics have proved to be useful. The medical regulation of the bone disease is of highest priority. On account of the pain, bone stability and deformation, conservative and operative therapy such as osteosynthesis or THR has to be performed.
Gaulke
R
R
Evangelische Stiftung Volmarstein - Orthopädische Klinik der Universität Witten/Herdecke, Abt. für Rheumaorthopädie, Handchirurgie und arthroskopische Chirurgie, Germany.
D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D001851:Bone Diseases, Metabolic / Q000150:complications / Q000000981:diagnostic imaging; D002762:Cholecalciferol / Q000172:deficiency; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications / Q000000981:diagnostic imaging; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D012307:Risk Factors
D002762:Cholecalciferol