Bilateral Non-traumatic Neglected Femoral Neck Fracture in a Healthy Adolescent: A Case Report and Review of Literature.

Introduction: Bilateral femoral neck fracture in children is uncommon and is extremely rare in the absence of significant injury or any underlying systemic and local bone disease. Diagnosis in these healthy children is usually delayed due to the presence of mild symptoms and lack of suspicion for a fracture. Case Report: We report a case of 13-year-old girl with a bilateral neck of femur fracture without any history of trauma or any underlying systemic or local disease. The child presented to us 6 months after the onset of symptoms and was managed by osteosynthesis and valgus intertrochanteric osteotomy. The fractures on both sides healed satisfactorily without any evidence of avascular necrosis of the femoral head. However, nonunion of the intertrochanteric osteotomy was observed on the left side. It was subsequently managed by open reduction and bone grafting and healed satisfactorily thereafter. The relevant literature about this rare case has been discussed. Conclusion: Management of late presenting fractured neck femur is more complex and often needs more invasive procedures. Besides, it is known to increase the risk of complications and compromise the treatment outcome. Hence, it is important to realize the possibility of a fracture neck femur in an otherwise normal child and such children should be evaluated and treated at the earliest for a better outcome.