Bilateral Neck Femur Fracture Following a Generalized Seizure- A Rare Case Report

Document Type : CASE REPORT


MS Ramaiah Medical College, Bangalore, Karnataka ,India


Hip fractures are one of the most common injuries which present to an orthopaedic surgeon. Most of these cases are unilateral .Bilateral simultaneous femur neck fracture is a rare occurrence. We report a case of a bilateral neck femur fracture in a 30 year male following a generalized tonic clonic seizure in view of its rarity and also to increase the awareness of such rare injuries. The patient was operated within 3 hours. At 5 months, the patient had good radiological and functional outcome. During a convulsion, there is a powerful and forceful contraction of muscles which may lead to fracture or dislocation. The incidence of fractures following a convulsion is 1.1%. A delay in diagnosis can lead to complications like avascular necrosis, osteoarthritis, non union, functional disability and legal consequences. All orthopaedic surgeons and emergency physicians should be aware of such uncommon injuries to ensure early diagnosis and treatment.


  1. Grimaldi M, Vouaillat H, Tonetti J, Merloz P. Simultaneous bilateral femoral neck fractures secondary to epileptic seizures:treatment by bilateral total hip arthroplasty. Orthop Traumatol Surg Res. 2009; 95(7):555-7
  2. Rahman MM, Awada A. Bilateral simultaneous hip fractures secondary to an epileptic seizure. Saudi Med J. 2003; 24(11):1261-3.
  3. Mosekilde L, Hansen HH, Christensen MS, Lund B, Sorensen OH, Melsen F, et al. Fractional intestinal calcium absorption in epileptics on anticonvulsant therapy: short term effects of 1,25-dihydroxycholecalciferol and 25-hydroxycholecalciferol. Acta Med Scand. 1979; 205(5):405-9.
  4. Sakai S, David D, Shoji H, Stenzel KH, Rubin AL. Bone injuries due to tetany or convulsions during hemodialysis. Clin Orthop Relat Res. 1976;(118):118-23.
  5. Vanderhooft E, Swiontkowski M. Bilateral femoral neck fractures following a grand mal seizure. Ann Emerg Med. 1994; 24: 1188-91.
  6. Haronian E, Silver JW, Mesa J. Simultaneous bilateral femoral neck fracture and greater tuberosity shoulder fracture resulting from seizure. Orthopedics. 2002; 25(7):757-8.
  7. Taminiau AH, Slooff TJ. Bilateral femoral neck fractures as a complication of myelography. Acta Orthop Scand. 1980;51(4):621-4.
  8. Ribacoba-Montero R, Salas-Puig J. Simultaneous bilateral fractures of the hip following a grand mal seizure. An unusual complication. Seizure. 1997; 6(5):403-4.
  9. Taylor LJ, Grant SC. Bilateral fracture of the femoral neck during a hypocalcaemic convulsion. A case report. J Bone Joint Surg Br. 1985; 67(4):536-7.
  10. Rath E, Levy O, Liberman N, Atar D. Bilateral dislocation of the hip during convulsions. J Bone Joint Surg Br. 1997; 79(2):304-6.
  11. Marsh JP, Leiter JRS, MacDonald P. Bilateral femoral neck fractures resulting from a grand mal seizure in an elderly man with Down syndrome. Orthop Rev (Pavia). 2010; 2(1): e10.
  12. Finelli PF, Cardi JK. Seizure as a cause of fracture. Neurology. 1989;39(6):858-60
  13. Friedberg R, Buras J. Bilateral acetabular fractures associated with a seizure: a case report. Ann Emerg Med. 2005; 46(3):260-2.