Qingyu Zhang1, Fuqiang Gao2, Wei Sun3, Zirong Li2. 1. Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China. 2. Department of Orthopedics, China-Japan Friendship Hospital, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China. 3. Department of Orthopedics, China-Japan Friendship Hospital, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China. sunwei20180101@163.com.
Abstract
BACKGROUND: During a seizure, there is a powerful and forceful contraction of muscles which may lead to fractures or joint dislocations. However, multiple periprosthetic hip fractures and joint dislocations secondary to seizures have not been reported. CASE PRESENTATION: A 49-year-old male developed spontaneous and bilateral multiple periprosthetic hip fractures and joint dislocations (including displaced fracture of the proximal right femur, avulsion fracture of the left lesser trochanter, left acetabular fracture and bilateral joint dislocations) secondary to generalized convulsive seizures which occurred within few hours after bilateral total hip arthroplasties (THAs). Bilateral open reconstruction and fixation were performed on the 21st day after primary THAs and on 2-year follow-up, the patient showed satisfactory functional outcome. CONCLUSIONS: Multiple periprosthetic hip fractures and joint dislocations secondary to seizure are extremely rare, and treatment targets for these injuries should focus on fracture healing and limb function recovery. Craniocerebral operation could bring an elevated risk of seizure; meanwhile, subsequent corticosteroid replacement threapy was complicated by secondary osteoporosis. Therefore, anti-osteoporotic and anti-epileptic therapy should be considered in this type of patients to avoid fracture and dislocation after arthroplasty.
BACKGROUND: During a seizure, there is a powerful and forceful contraction of muscles which may lead to fractures or joint dislocations. However, multiple periprosthetic hip fractures and joint dislocations secondary to seizures have not been reported. CASE PRESENTATION: A 49-year-old male developed spontaneous and bilateral multiple periprosthetic hip fractures and joint dislocations (including displaced fracture of the proximal right femur, avulsion fracture of the left lesser trochanter, left acetabular fracture and bilateral joint dislocations) secondary to generalized convulsive seizures which occurred within few hours after bilateral total hip arthroplasties (THAs). Bilateral open reconstruction and fixation were performed on the 21st day after primary THAs and on 2-year follow-up, the patient showed satisfactory functional outcome. CONCLUSIONS: Multiple periprosthetic hip fractures and joint dislocations secondary to seizure are extremely rare, and treatment targets for these injuries should focus on fracture healing and limb function recovery. Craniocerebral operation could bring an elevated risk of seizure; meanwhile, subsequent corticosteroid replacement threapy was complicated by secondary osteoporosis. Therefore, anti-osteoporotic and anti-epileptic therapy should be considered in this type of patients to avoid fracture and dislocation after arthroplasty.
Authors: R Pascarella; P Sangiovanni; S Cerbasi; R Fantasia; O Consonni; V Zottola; A Panella; B Moretti Journal: Injury Date: 2018-11 Impact factor: 2.586
Authors: Jesús Moreta; Urko Aguirre; Oskar Sáez de Ugarte; Iñaki Jáuregui; José Luis Martínez-De Los Mozos Journal: Injury Date: 2014-07-19 Impact factor: 2.586