MANAGEMENT OF BILATERAL FEMORAL NECK FRACTURE IN A NONAGENARIAN PATIENT--CASE REPORT

Area of Science:

• Orthopedic Surgery
• Geriatric Trauma
• Bone Pathophysiology

Background:

• Simultaneous bilateral femoral neck fractures are uncommon, historically linked to electroconvulsive therapy or high-energy trauma in younger individuals.
• Pathological bone changes (osteoporosis, vitamin D deficiency, etc.) predispose individuals to these fractures from low-energy events.
• Elderly patients with comorbidities are at increased risk for fragility fractures.

Observation:

• A 90-year-old female sustained a Garden IV bilateral femoral neck fracture from a simple fall.
• The patient presented with comorbidities increasing fracture risk.
• The fracture pattern indicated significant bone compromise despite low-energy trauma.

Findings:

• Bilateral uncemented bipolar hemiarthroplasty was performed in a single session.
• The procedure utilized a single set of sterile instruments and drapes.
• Excellent postoperative outcomes were achieved, enabling early functional recovery.

Implications:

• Uncemented hemiarthroplasty is a viable and effective treatment for simultaneous bilateral femoral neck fractures in elderly patients.
• This approach avoids the risks associated with bone cement implantation syndrome, particularly relevant in patients with cardiovascular concerns.
• Early mobilization following surgery is feasible and crucial for geriatric fracture recovery.