Bilateral neglected femoral neck fracture due to vitamin D deficiency osteomalacia treated with total hip arthroplasty: A case report

Bilateral femoral neck fractures in young adults are rare and often result from trauma or underlying conditions like osteomalacia. Osteomalacia-related fractures are often treated late due to poor bone quality and untreated metabolic issues. In this case, the patient presented with a high-positioned dislocated hip resulting from old femoral neck fractures, which were successfully treated with total hip arthroplasty (THA). A 31-year-old man with severe food allergies and atopic dermatitis developed bilateral femoral neck fractures due to vitamin D deficiency-induced osteomalacia. Poor bone quality initially made surgery unfeasible, leaving him wheelchair-bound for 13 years. After treating the vitamin D deficiency and improving bone quality, bilateral THA was performed at age 44. Fifteen weeks postoperatively, the patient was able to walk independently. Osteomalacia-associated fractures require complex management due to delayed treatment. Recovery in this case was achieved by addressing osteomalacia first, followed by bilateral THA.