Bilateral Intertrochanteric Femur Fractures in a Paraplegic Patient: A Case Report

Cureus, 2024 · DOI: 10.7759/cureus.54883 · Published: February 25, 2024

Simple Explanation

This case report describes a rare occurrence of bilateral intertrochanteric (IT) femur fractures in a 72-year-old paraplegic woman after a wheelchair accident. The patient was treated with single-stage bilateral cephalomedullary nail fixation to improve her ability to transfer and reduce pain. The patient's pain resolved, and she regained her pre-injury transfer ability, but she passed away six months later due to unrelated causes.

Study Duration

Short-term follow-up

Participants

One 72-year-old paraplegic female

Evidence Level

Level 4: Case Report

Key Findings

1
Single-stage cephalomedullary fixation can be an effective treatment for bilateral IT femur fractures in paraplegic patients, relieving pain and improving transfers.
2
Long-standing spinal cord injury may be an underappreciated risk factor for bilateral hip fractures.
3
Surgical fixation appears to be an appropriate choice of treatment, especially if patients experience pain and instability when transferring.

Research Summary

This case report presents the unique instance of a 72-year-old paraplegic woman who sustained bilateral intertrochanteric (IT) femur fractures following a wheelchair accident. The patient underwent single-stage bilateral cephalomedullary nail fixation, which resulted in pain relief and improved transfer ability, returning her to her pre-injury functional level. Although the patient passed away six months post-surgery due to unrelated causes, the case suggests that surgical fixation can be a viable treatment option for bilateral IT fractures in paraplegic patients to improve their quality of life.

Practical Implications

Surgical Treatment Considerations

This case highlights the potential benefits of surgical intervention, specifically cephalomedullary nail fixation, for paraplegic patients with bilateral IT femur fractures to improve mobility and reduce pain.

Risk Factor Awareness

Long-term spinal cord injury should be considered as a potential risk factor for hip fractures, especially bilateral fractures, informing preventative care strategies.

Individualized Treatment Approach

The decision to pursue surgical management should carefully consider the patient’s overall health, pre-injury functional status, and potential risks associated with paraplegia.

Study Limitations

1
Short follow-up period limits long-term outcome assessment.
2
Single case report provides limited generalizability.
3
Patient had pre-existing conditions (sacral ulcer, MRSA history, UTI) that could influence outcomes.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury