CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(02): 254-257
DOI: 10.1016/j.rbo.2017.12.024
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Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Bilateral Femoral Neck Fracture Secondary to Seizure: Treatment with Total Hip Arthroplasty by the Direct Anterior approach[*]

Article in several languages: português | English
Osamu de Sandes Kimura
1  Instituto Nacional de Traumatologia e Ortopedia (Into), Rio de Janeiro, RJ, Brasil
,
Rui Felipe Pache de Moraes
1  Instituto Nacional de Traumatologia e Ortopedia (Into), Rio de Janeiro, RJ, Brasil
,
1  Instituto Nacional de Traumatologia e Ortopedia (Into), Rio de Janeiro, RJ, Brasil
,
Emílio Henrique Carvalho Freitas
1  Instituto Nacional de Traumatologia e Ortopedia (Into), Rio de Janeiro, RJ, Brasil
,
Alexandre Seabra
1  Instituto Nacional de Traumatologia e Ortopedia (Into), Rio de Janeiro, RJ, Brasil
,
George Kalif Lima
1  Instituto Nacional de Traumatologia e Ortopedia (Into), Rio de Janeiro, RJ, Brasil
› Author Affiliations
Further Information

Publication History

19 September 2017

14 December 2017

Publication Date:
03 February 2020 (online)

Abstract

Bilateral fracture of the femoral neck secondary to seizure is a rare event. The occurrence of these lesions is related to vigorous tonic-clonic muscular contractions and to the use of anticonvulsive medications. Femoral neck fractures in young adults treated with total hip arthroplasty are the exception, and the choice of surgical access should consider several factors; the direct anterior approach is a possibility for total hip arthroplasty.

The authors present the case of a 36-year-old male with bilateral fracture of the femoral neck secondary to seizure, and in regular use of phenytoin. Due to the risk of fixation failure and prolonged evolution time, bilateral total hip arthroplasty was the procedure of choice. The choice of the approach should take into consideration the patient's anatomy, material availability, and surgeon's experience. Thus, the greater ease of preparation and positioning of the patient, the shorter hospital stay, the early postoperative rehabilitation, and the mastery of the technique by the surgeon, are possible justifications for the adoption of the direct anterior approach.

* Study developed at Hip Surgery Center, National Institute of Traumatology and Orthopedics (Into), Rio de Janeiro, RJ, Brazil.