Non-traumatic Unilateral Femur Neck Fracture in a Human Immunodeficiency Virus-Positive Septuagenarian Indian Male: A Unique Case Report

• Published in: Journal of orthopaedic case reports Vol. 8; no. 5; p. 75
• Main Authors: Ramanath, Sharath Kittanakere, Shah, Rahul Hemant
• Format: Journal Article
• Language: English
• Published: India 01.09.2018
• Subjects: Bipolar hip hemiarthroplasty; human immunodeficiency virus-positive; Abacavir; Femur neck; Lamivudine; Efavirenz
• ISSN: 2250-0685; 2321-3817

Antiretroviral drugs are known to cause osteoporosis making the bones susceptible to fracture. Osteoporotic fractures are majorly seen in the vertebral bodies. Pathological fractures need to be fixed without much delay to start mobilization of the patients. The present case describes a 72-year-old male who was diagnosed to be human immunodeficiency virus-positive 11 months back for which the patient was on a combination of antiretroviral therapy for 11 months. The patient was a farmer by occupation. The patient presented to us with left sided hip pain for1 week with no history of trauma or fall. The patient was able to walk approximately 100m with the help of a height adjustable walker. However, activities such as squatting and sitting cross-legged were restricted for1 week. Radiographic examination revealed a fracture of the left neck of the femur. The patient was evaluated for metastasis the investigations for which were negative. Bipolar hemiarthroplasty of the hip was done since radiographically and intraoperatively no changes were noted in the acetabulum which would have changed the plan to total hip replacement. Following the surgery, patient started walking full-weight bearing from the very next day after surgery. This case concludes the potential of antiretroviral drugs such as abacavir, lamivudine and efavirenz to cause pathological fractures which has never been described in literature before.