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Europace Advance Access originally published online on July 13, 2007
Europace 2007 9(10):957-958; doi:10.1093/europace/eum134
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

MISCELLANEOUS

An uncommon cause for hip fracture

Stijn de Ridder*, Carl Timmermans and Hein J.J. Wellens

Department of Cardiology, Academic Hospital Maastricht, P. Debyelaan 25, 6202 AZ Maastricht, The Netherlands

Manuscript submitted 8 May 2007. Accepted after revision 11 June 2007.

* Corresponding author. Tel: +31 43 387 5095; fax: +31 43 387 5104. E-mail address: spjderidder{at}yahoo.com

Key Words: Atrial fibrillation, Electrical cardioversion, Complications, Bone fracture

A 76-year-old woman with mild mitral regurgitation secondary to a mitral valve prolapse was referred for electrical cardioversion of her first episode of symptomatic atrial fibrillation. A single, 200 J, monophasic shock restored sinus rhythm. During recovery, she complained of severe pain in her left hip, and a shortening with external rotation of her left leg was noticed. A pelvic X-ray showed a left subtrochanteric femur fracture (Figure 1) on the same location where 9 years earlier a consolidated stress fracture was diagnosed. A long intramedullary nail was inserted in the left femur on the same day. Histological analysis of bone fragments showed no signs of malignancy. An extensive workup, including laboratory analysis for metabolic disorders and bone densitometry, revealed no abnormality. The femur fracture was, most likely, related to the external cardioversion in a patient with coxa vara and a previous stress fracture. After 3 months, atrial fibrillation recurred and rate-control medication was prescribed.


Figure 1
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  		Figure 1 Left subtrochanteric femur fracture.

 
Conflict of interest: none declared.


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This Article
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eum134v1
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