Simultaneous bilateral femoral neck fractures secondary to epileptic seizures: Treatment by bilateral total hip arthroplasty

• Published in: Orthopaedics & traumatology, surgery & research surgery & research, 2009-11, Vol.95 (7), p.555-557
• Main Authors: Grimaldi, M, Vouaillat, H, Tonetti, J, Merloz, P
• Format: Article
• Language: English
• Subjects: Arthroplasty, Replacement, Hip; Bilateral femoral neck fracture; Ceramic bearing surfaces; Ceramics; Delayed Diagnosis; Epilepsy; Epilepsy, Tonic-Clonic - complications; Femoral Neck Fractures - classification; Femoral Neck Fractures - diagnosis; Femoral Neck Fractures - etiology; Femoral Neck Fractures - surgery; Fracture; Humans; Joint Prosthesis; Male; Middle Aged; Orthopedics; Prosthesis Design; Seizures; Surgery
• ISSN: 1877-0568; 1877-0568
• DOI: 10.1016/j.otsr.2009.04.018

Summary Simultaneous bilateral femoral neck fracture following an epileptic seizure attack are rare. Open reduction and internal fixation remains the most used therapeutic option. Arthroplasty, carrying a high risk of dislocation is less often recommended. We report the favourable evolution of a 49-year-old man who benefited from a single stage bilateral total hip arthroplasty operation for his simultaneous bilateral, femoral neck fractures secondary to a generalized seizure. This nonconsensual choice, in this case, was justified on multiple grounds: surgical care delay longer than 48 hours, substantial bone displacement, borderline bone quality, adequate antiepileptic treatment efficacy and tolerance. A ceramic-on-ceramic bearing surfaces couple, a large-diameter head and a cementless implantation design together should be able to provide an acceptable longevity in a young and active patient.