PDF(Pubmed)
Abstract：
BACKGROUND Renal osteodystrophy is a serious complication of advanced chronic kidney disease (CKD). It predisposes the patient to fragility fracture and an increased risk of mortality. CASE REPORT We present the case of a 50-year-old male patient with stage 4 CKD and consequent renal osteodystrophy, who presented with a history of a recent provoked seizure, a severe electrolyte imbalance, and excruciating pain in the hip region. He had no history of a fall or trauma. A radiographic evaluation confirmed the rare finding of a bilateral femoral neck fracture. Upon stabilizing the patient, he was surgically managed with a bilateral hemiarthroplasty. A postoperative radiograph revealed a well-fixed prosthesis with no post-surgical complications. The patient had a full recovery. At the last follow-up visit, the patient was fully functional and had resumed normal activities. CONCLUSIONS This is a rare report with unusual mechanism of injury, involving a case of bilateral femoral neck fragility fractures, secondary to renal osteodystrophy in a stage 4 CKD patient. It draws the attention of medical care providers to the high risk of femoral fragility fractures that are secondary to renal osteodystrophy. Hemiarthroplasty is a safe and highly efficacious surgical option for managing such cases. This case also reiterates the dire need for greater public awareness and knowledge of CKD. Early diagnosis and treatment can substantially mitigate the associated morbidity and mortality.
摘要：
背景技术肾性骨营养不良是晚期慢性肾病(CKD)的严重并发症。它使患者容易出现脆性骨折和死亡风险增加。病例报告我们介绍了一个50岁的男性患者，患有4期CKD和随后的肾性骨营养不良，他有最近一次癫痫发作的历史，严重的电解质失衡，髋部剧痛.他没有跌倒或外伤史。影像学评估证实了双侧股骨颈骨折的罕见发现。稳定病人后,他接受了双侧半髋关节置换术的手术治疗。术后X光片显示假体固定良好，无术后并发症。病人完全康复了。在最后一次后续访问中，患者功能齐全,恢复正常活动.结论这是一个罕见的报道，具有异常的损伤机制，涉及双侧股骨颈脆性骨折，继发于4期CKD患者的肾性骨营养不良。它提请医疗保健提供者注意继发于肾性骨营养不良的股骨脆性骨折的高风险。半关节成形术是处理此类病例的安全且高效的手术选择。此案例还重申了迫切需要提高公众对CKD的认识和了解。早期诊断和治疗可以大大减轻相关的发病率和死亡率。
