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      Osteomalacia and coxa vara. An unusual co-existence for femoral neck stress fracture

      case-report

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          Highlights

          • Femoral neck stress fractures are not uncommon.

          • Osteomalacia is a common cause of insufficiency fractures.

          • Coxa vara is a rare cause of femoral neck stress fractures.

          • Co-existence of osteomalacia and coxa vara is a rare condition.

          Abstract

          Introduction

          Femoral neck stress fractures are not uncommon. Several causes exist about these fractures. Osteomalacia is one of the most common cause of insufficiency fractures and coxa vara can produce a focal concentration of mechanical stress in the femoral neck and may cause stress fractures. This case study is about the co-existence of these two pathologies in a patient with bilateral femoral neck stress fracture.

          Presentation of case

          A 26-year-old woman admitted to our department with a complaint of bilateral groin pain and diagnosed as bilateral coxa vara and osteomalacia. Medical treatment for osteomalacia and staged bilateral Pauwels’ osteotomy was performed. After 2 years of follow-up, good result was obtained.

          Discussion

          There are several risk factors for stress fractures and osteomalacia and coxa vara are two of the causes. Osteomalacia results in softening of the bones and coxa vara can produce a focal concentration of stresses in the femoral neck.

          Conclusion

          Joint and bone pain without any trauma should be investigated and bone metabolism disorders should be kept in mind. There might be co-existing factors related with stress fractures, and they must be treated simultaneously.

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          Most cited references23

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          Diagnosis and management of vitamin D deficiency.

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            Femoral neck stress fractures.

            Fifty-four femoral neck stress fractures were studied prospectively to evaluate treatment methods. Fifty-four fractures in 49 patients were identified in a 4 year prospective study that included 1,049 stress fractures of all types. From our evaluation of treatment methods, a modification of existing classification systems was developed based on radiographic findings and treatment. Differences from earlier studies were noted in racial diversity, in nonprogression of tension-side fractures, and in return to function.
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              Frequency of osteomalacia and osteoporosis in fractures of the proximal femur.

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                Author and article information

                Contributors
                Journal
                Int J Surg Case Rep
                Int J Surg Case Rep
                International Journal of Surgery Case Reports
                Elsevier
                2210-2612
                03 October 2015
                2015
                03 October 2015
                : 16
                : 137-140
                Affiliations
                [a ]Department of Orthopedics and Traumatology, Acibadem Atakent University Hospital, Halkali/Kucukcekmece, Istanbul 34303, Turkey
                [b ]Department of Orthopedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Fatih/Capa, Istanbul 34093, Turkey
                Author notes
                [* ]Corresponding author at: Department of Orthopedics and Traumatology, Acibadem Atakent University Hospital, Halkali/Kucukcekmece, Istanbul 34303, Turkey. Fax: +90 212 404 44 45. ksariyilmaz@ 123456gmail.com ksariyilmaz@ 123456yahoo.com
                Article
                S2210-2612(15)00426-5
                10.1016/j.ijscr.2015.09.034
                4643467
                26454499
                7fb0d0d5-1aef-4bea-831c-e44196c8a66c
                © 2015 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 24 July 2015
                : 21 September 2015
                : 25 September 2015
                Categories
                Case Report

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