Spontaneous sub-capital fracture neck of femur complicating a united Trochanteric fracture in a diabetic- case report and review of literature

Introduction: Spontaneous subcapital femoral neck fracture is one of the rare complications arising after metallic fixation of peritrochanteric fractures. Its association with osteoporosis, old age, female sex and alcohol induced osteoporosis has been described in literature but to the best of our knowledge its association with diabetes has not been described. Case Presentation: A 60 year old male, Diabetic, Asian Indian in origin presented to us as trauma right hip with intertrochanteric fracture. The patient developed spontaneous subcapital femoral neck fracture after 24 months of Dynamic hip screw fixation. The patient was reoperated, after removal of hardware appropriate size bipolar prosthesis was placed. Conclusion: Spontaneous subcapital femoral neck fracture even though being an uncommon complication, one should still be very vigilant about this sort of a complication after any metallic trochanteric fracture fixation or after removal of the implant, especially in patients who are elderly osteoporotic or have added risk factors like being alcoholic or being diabetic as was our patient.