Cases reported "Fractures, Spontaneous"

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11/61. Transient osteoporosis with bilateral fracture of the neck of the femur during pregnancy: a case report.

    A case of bilateral non-nion of femoral neck fracture during the last trimester of pregnancy was reported. Bilateral hemiarthroplasty with bipolar prosthesis was performed in May, 2000. The result after one year follow-up was excellent.
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12/61. Bilateral pathologic fractures of the hip and acetabulum treated with cementless total hip arthroplasty.

    Pathologic fractures from metastatic cancer pose formidable challenges to the orthopaedic surgeon technically and in terms of surgical decision making with regards to patient quality of life. We present the case of a 47-year-old woman with simultaneous bilateral pathologic femoral neck and acetabulum fractures and severe pulmonary shunt, who was treated successfully with cementless femoral and acetabular implants.
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13/61. Management of pathological fracture neck of the femur following recent osteomyelitis in a child.

    Fracture neck of the femur is rare in children and occurs following severe trauma. Several recommendations have been made for the treatment of displaced transcervical fracture type 11 (Delbet classification). However there are no recommendations when such a fracture occurs after recent acute osteomyelits of the neck of the femur. The management of a case is described with the outcome after 36 months.
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14/61. Seizure-induced thoracic spine compression fracture: case report.

    BACKGROUND: Vertebral fracture caused solely by a convulsive seizure has rarely been reported in the neurosurgical literature. CASE DESCRIPTION: We describe a 34-year-old male with severe back pain from a thoracic fracture occurring in association with a seizure during hospitalization for treatment of temporal lobe epilepsy. Bone mineral densities in the lumbar spine and the femoral neck were decreased, possibly by long-term anti-epileptic medication. Muscle contractions during a seizure can result in vertebral fractures, especially at the thoracic levels. CONCLUSION: A complaint of back pain after a convulsive seizure should prompt radiologic investigation for vertebral fracture, even in the absence of external trauma.
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15/61. Insufficiency fracture of the femoral neck during osteoporosis treatment: a case report.

    Acase of insufficiency fracture of the femoral neck that occurred during treatment for osteoporosis is reported. A 77-year-old woman (height 150 cm, body weight 43 kg) with osteoporosis associated with high bone turnover was treated with oral cyclical etidronate (400 mg/day for 2 weeks every 3 months). Three months after the treatment was started the patient experienced pain in the right hip joint while walking despite no evidence of trauma. Although radiographs were normal, weight-bearing was not possible because of pain. T2-weighted magnetic resonance (MR) imaging was used to detect a fracture line localized on the inferior aspect of the femoral neck. Because on bone marker measurement bone resorption was increased and bone formation was decreased from baseline, treatment was switched to oral alendronate (5 mg/day, daily). Pain resolved 3 weeks after the fracture was evident, and free gait was possible during the following 3 weeks. Follow-up radiographs, obtained 3 and 6 months after the fracture was evident, showed bony sclerosis on the aspect in which the fracture line was observed on the T2-weighted MR image. The dissociation (imbalance) of bone formation and resorption was also alleviated. A possibility of increased bone fragility should be kept in mind when oral cyclical etidronate is applied to elderly Japanese, small-physique women with osteoporosis at a daily dose of 400 mg (higher dose).
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16/61. Simple bone cyst with pathologic lumbar pedicle fracture: a case report.

    STUDY DESIGN: A case report and review of the literature are presented. OBJECTIVE: To describe an unusual simple bone cyst involving the pedicle of lumbar spine. SUMMARY OF BACKGROUND DATA: To the authors' knowledge, only nine cases of a simple bone cyst involving the spine have been reported. Most of these reports have described mild back or neck pain because the presenting symptoms or cysts were found incidentally. In the reported case, acute severe back pain with radiating pain developed. Therefore, the study focus was on the unusual location, the presenting symptoms, and its spinal involvement. methods: A cystic lesion involving the left pedicle of the first lumber vertebra was identified in a 53-year-old woman with sudden-onset severe back pain with pain radiating to the left leg. Surgical resection was undertaken along with review of the patient's medical record, imaging studies, microscopic findings of the lesion, and the related literature. RESULTS: Microscopic examination of the cystic lesion corresponded with the findings of a simple bone cyst. A thin fibrous membrane with reactive bone formation was identified without evidence of hemorrhage. A favorable result was achieved by surgical resection. CONCLUSIONS: This case study suggests that a simple bone cyst may be found in any portion of the spine, including the pedicle. Severe resting pain would be elicited by a pathologic fracture of the pedicle. Direct nerve compression by the fractured fragment and chemical irritation by cystic fluid would be compatible with the observed clinical manifestations.
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17/61. Decreased cutaneous vitamin d-synthesis in heavily melanized individuals: a rare cause for pathologic fractures of the hip.

    Painful pathological fractures of the femoral neck and the subtrochanteric region of the femur are reported in two women originating from india. After exclusion of renal or intestinal causes, laboratory data on bone metabolism, scintigraphic and radiographic examinations were characteristic for the presence of secondary hyperparathyroidism. Based on vitamin deficiency and low calcium absorption, disturbed mineralization of bone and increased osteoclastic resorption have apparently led to osteomalacia and subsequent fracturing. Fracture localization necessitated surgical fixation in one patient; conservative treatment including protected weightbearing was effective in the other women. After supplementation of calcium and vitamin D3, levels of parathyroid hormone and scintigraphic alterations returned to normal in both patients. In these two cases, pathological fractures of the hip could be attributed to the presence of secondary hyperparathyroidism based on decreased cutaneous vitamin d synthesis.
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18/61. Bilateral simultaneous combined intra- and extracapsular femoral neck fracture secondary to nutritional osteomalacia: a case report.

    A case of bilateral simultaneous combined extra- and intracapsular femoral neck fractures is presented in an adult Asian male patient suffering from nutritional osteomalacia. The radiological and biochemical findings were classical for osteomalacia with Looser's zones affecting the shoulder and the pelvic girdle. Treatment consisted of bed rest and calcium and vitamin-D replacement. The fractures healed without surgery. A high index of suspicion for nutritional osteomalacia among Asian immigrants especially among the low socio-economic classes is required in the Western community. early diagnosis and treatment prevents chronic disability and skeletal deformity.
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19/61. Multiple insufficiency fractures with severe osteoporosis.

    Multiple insufficiency fracture is a rare injury. We report a 63-year-old woman who spontaneously developed insufficiency fractures at multiple sites including ribs, sacrum, pubis, ischium, acetabulum, metatarsal bone, and femoral neck. The patient had severe osteoporosis with a bone mineral density of 0.267 g/cm(2), although there was no evidence of bone metabolic disease or metastatic bone tumor. risk factors for osteoporosis in this case were her postmenopausal state and a history of gastrectomy. Interestingly, the serum level of insulin-like growth factor i, recognized as a growth factor that stimulates bone formation, was markedly decreased, and the patient had had viral hepatitis c. It was speculated that the synergistic effects of these disorders might have produced the osteoporosis, leading ultimately to the multiple insufficiency fractures.
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20/61. Brown tumor of the femur associated with double parathyroid adenomas.

    Severe parathyroid bone disease is a rare clinical presentation of primary hyperparathyroidism. Double parathyroid adenomas are even more rare cause of primary hyperparathyroidism. The authors present a case of double parathyroid adenomas in a 48-year-old man, who presented with painful left lower limb swelling, which was slowly growing in size in the last 20 years. magnetic resonance imaging revealed a cystic bony lesion and coincidentally, a urinary bladder calculus. biopsy of the mass revealed giant cell lesion. Laboratory investigations showed hypercalcemia and hypophosphatemia with elevated parathyroid hormone level. A computerized tomography scan of the neck delineated an adenoma of the left superior parathyroid gland, which was surgically removed. The left inferior parathyroid was also enlarged and was removed. Histological diagnosis confirmed double parathyroid adenomas. The rarity and the interesting clinical presentation of such association are discussed.
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