Singh Vinay K, Singh Pankaj K, Elliot Andrew C
Department of Trauma and Orthopaedics Surgery, James Paget University Hospital, Great Yarmouth, UK.
Department of Trauma and Orthopaedics Surgery, James Paget University Hospital, Great Yarmouth, NR31 6LA, UK.
Eur J Trauma Emerg Surg. 2009 Feb;35(1):81. doi: 10.1007/s00068-008-7179-9. Epub 2008 Sep 20.
Spontaneous fractures involving both of the femoral necks simultaneously are exceedingly rare events. We report a case of an elderly female who presented after breaking both femoral necks following a trivial fall, initially diagnosed as age-related osteoporosis. Both the hips were treated by hemiarthroplasty. The diagnosis was revised to vitamin D-resistant osteomalacia secondary to hypomagnesemia after histopathological confirmation and further investigations. We examine the different etiological factors and mechanisms operating in the causation of this rare injury and explore the possible role of magnesium in the pathogenesis of osteomalacia. Fractures may remain occult until late, leading to increased morbidity and mortality. The value of an early MRI is recapitulated, with emphasis placed on prevention and early fixation.
双侧股骨颈同时发生的自发性骨折是极为罕见的事件。我们报告一例老年女性病例,她在一次轻微跌倒后双侧股骨颈骨折,最初被诊断为年龄相关性骨质疏松症。双侧髋关节均接受了半髋关节置换术。经组织病理学证实和进一步检查后,诊断修订为继发于低镁血症的维生素D抵抗性骨软化症。我们研究了导致这种罕见损伤的不同病因和机制,并探讨了镁在骨软化症发病机制中的可能作用。骨折可能在晚期之前一直隐匿,导致发病率和死亡率增加。再次强调了早期MRI的价值,重点在于预防和早期固定。