J Bone Metab.  2017 May;24(2):135-139. 10.11005/jbm.2017.24.2.135.

Pathological Fracture of Femoral Neck Leading to a Diagnosis of Wilson's Disease: A Case Report and Review of Literature

• Bhatnagar
• Lingaiah P
• Lodhi JS
• Karkhur Y

• KMID: 2379996
• DOI: http://doi.org/10.11005/jbm.2017.24.2.135

Abstract

Wilson's disease (WD) is a rare inherited disorder of copper metabolism. It chiefly has hepatic, neurological and ophthalmic manifestations. Although osteoporosis, rickets and early arthritis are common features of WD, they are under-recognized. Musculoskeletal manifestations very rarely lead to diagnosis of the disease. Here we present a case of a 12-year-old girl who presented with a 3-month-old pathological fracture of neck of femur. WD was diagnosed on investigating the cause of the pathological fracture, which was managed by performing a conventional McMurray's intertrochanteric osteotomy. At 6 months follow up, fracture had united and patient was able to ambulate with support. WD can be a rare cause of pathological fracture. A high index of suspicion must be maintained in patients of pathological fracture presenting with associated neuropsychiatric or hepatic manifestations.

Keyword

Femur neck; Fractures spontaneous; Hepatolenticular degeneration

MeSH Terms

Arthritis
Child
Copper
Diagnosis*
Female
Femur
Femur Neck*
Follow-Up Studies
Fractures, Spontaneous*
Hepatolenticular Degeneration*
Humans
Infant
Metabolism
Neck
Osteoporosis
Osteotomy
Rickets
Copper

Figure

• 

  Fig. 1 Plain radiograph (antero-posterior view) revealing a fracture of femoral neck. Femoral diaphyseal cortices appear thinned out and greater trochanter appears osteoporotic.

• 

  Fig. 2 Immediate post-operative radiograph following McMurray osteotomy.

• 

  Fig. 3 Three months post-operative radiographs antero-posterior (A) and lateral (B) views showing signs of union at osteotomy site and non-union site.

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