An uncommon cause for hip fracture
An uncommon cause for hip fracture
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DOI：
10.1093/europace/eum134
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发表时间：
2007-10-01
期刊：
影响因子：
6.1
通讯作者：
Wellens, Hein J. J.
中科院分区：
文献类型：
--
作者：
de Ridder, Stijn;Timmermans, Carl;Wellens, Hein J. J.
一名76岁的女性，患有继发于二尖瓣脱垂的轻度二尖瓣返流，因首次症状性房颤发作而接受电击复律。单次200 J单相电击恢复了窦性心律。在恢复期间，她主诉左髋关节剧烈疼痛，并注意到左腿外旋缩短。骨盆X线片显示左侧转子下股骨骨折（图1），位于9年前诊断为应力性骨折的同一位置。同一天，在左侧股骨中插入长髓内钉。骨碎片的组织学分析显示没有恶性肿瘤的迹象。广泛的检查，包括代谢紊乱的实验室分析和骨密度测定，未发现异常。股骨骨折很可能与髋内翻和既往应力性骨折患者的体外复律有关。3个月后，房颤复发，并开具了心率控制药物。
A 76-year-old woman with mild mitral regurgitation secondary to a mitral valve prolapse was referred for electrical cardioversion of her first episode of symptomatic atrial fibrillation. A single, 200 J, monophasic shock restored sinus rhythm. During recovery, she complained of severe pain in her left hip, and a shortening with external rotation of her left leg was noticed. A pelvic X-ray showed a left subtrochanteric femur fracture (Figure 1) on the same location where 9 years earlier a consolidated stress fracture was diagnosed. A long intramedullary nail was inserted in the left femur on the same day. Histological analysis of bone fragments showed no signs of malignancy. An extensive workup, including laboratory analysis for metabolic disorders and bone densitometry, revealed no abnormality. The femur fracture was, most likely, related to the external cardioversion in a patient with coxa vara and a previous stress fracture. After 3 months, atrial fibrillation recurred and rate-control medication was prescribed.