2025, Vol. 7, Issue 2, Part E
Management of same-side neglected femoral neck and subtrochanteric fractures in an elderly osteoporotic patient: A case report
Author(s): R Hariharasudhan, Sunil Kumar PC and Mohd Ejazul Haq Chand
Abstract: Background: Ipsilateral neglected femoral neck and subtrochanteric fractures in elderly osteoporotic patients are rare and complex injuries that pose significant management challenges due to poor bone quality, altered anatomy, and high risk of nonunion. Optimal treatment strategies require tailored surgical approaches and adjunctive therapies to restore function and prevent complications.
Case Presentation: A 65-year-old female presented with two months of worsening left hip pain following trivial trauma and inability to walk after a second fall one week prior. Physical examination showed left lower limb shortening and external rotation. Radiographs revealed a Sandhu type 3 neglected femoral neck fracture and a Russell-Taylor type 1A subtrochanteric femur fracture in severely osteoporotic bone (Singh index grade 1; Dorr type C). Surgical management involved a lateral approach with placement of a 250 mm uncemented long-stem bipolar prosthesis and cable fixation of both existing and iatrogenic fractures occurring intraoperatively.
Results: Postoperative care included Teriparatide, calcium, and vitamin D3 supplementation for six months. The patient underwent immobilization and passive range of motion exercises for eight weeks, progressing to gradual weight-bearing once radiologic evidence of union was confirmed. At six months, the patient achieved stable fixation, restored limb length, pain-free ambulation, and radiographic union.
Conclusion: This case highlights the effectiveness of cementless long-stem bipolar arthroplasty combined with cable augmentation and osteoporosis-specific pharmacotherapy for managing complex ipsilateral neglected femoral neck and subtrochanteric fractures in elderly osteoporotic patients. Early diagnosis, individualized surgery, and structured rehabilitation are crucial for successful outcomes.
DOI: 10.22271/27078345.2025.v7.i2e.295Pages: 263-265 | Views: 76 | Downloads: 34Download Full Article: Click Here
How to cite this article:
R Hariharasudhan, Sunil Kumar PC, Mohd Ejazul Haq Chand.
Management of same-side neglected femoral neck and subtrochanteric fractures in an elderly osteoporotic patient: A case report. Int J Case Rep Orthop 2025;7(2):263-265. DOI:
10.22271/27078345.2025.v7.i2e.295
