title: Femoral neck's fracture in Fahr's Syndrome: case report.
abstract: Fahr's syndrome, also known as "Bilateral Striopallidodentate Calcinosis" (BSPDC) primitive, is a rare neurological disease characterized by the presence of idiopathic, bilateral, symmetrical and abnormal deposition of calcium in areas of the brain that control movements including the basal ganglia, dentate nuclei of the cerebellum, nuclei of thalamus and semi-oval center. We describe a case of a 76-year-old male patient underwent reduction and fixation of a subtrochanteric fracture with intramedullary nail. During post-operative rehabilitation therapists's patient management was difficult due to obvious extrapyramidal symptoms characterized by dysarthria, rigidity, bradykinesia, postural instability. A CT scan, performed for the onset of stiffness and confusion before the operation, showed: IV ventricle eumorphic and in axis; expansion in atrophic sense of supratentorial ventricular system; bilateral, diffuse and coarse calcifications of the basal ganglia in the cerebellar and occipital cortex, elements compatible with Fahr's syndrome. The patient presented repeated postural instability episodes in the upright position, with loss balance tendency and recurrent falls. Fahr's syndrome patient is a "weak" patient, which requires a multi-disciplinary approach in order to prevent the mobility reduction, to improve the condition of postural instability, thus reducing the risk of fractures using preventive measures in domestic environment.
authors.affiliation: Physical Medicine and Rehabilitation Department, University of Palermo, Palermo, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Sallì
authors.affiliation: Orthopaedics and Traumatology Department, University of Palermo, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Arienzo
authors.affiliation: Physical Medicine and Rehabilitation Department, University of Palermo, Palermo, Italy.
authors.forename: Mariella
authors.initials: M
authors.lastname: Bonanno
authors.affiliation: Orthopaedics and Traumatology Department, University of Palermo, Palermo, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Morello
authors.affiliation: Orthopaedics and Traumatology Department, University of Palermo, Palermo, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Sanfilippo
authors.affiliation: Physical Medicine and Rehabilitation Department, University of Palermo, Palermo, Italy.
authors.forename: Giulia Letizia
authors.initials: GL
authors.lastname: Mauro
authors.affiliation: Orthopaedics and Traumatology Department, University of Palermo, Palermo, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: D'Arienzo
keywords: fracture; nail; pseudohypoparathyroidism; rehabilitation