PMC9669336_01
X--ray (A) and CT (D) showing a Garden IV fracture of the left femoral neck. The x-ray (B) and CT (E,G) showing bone resorption at the fracture site with internal fixation loosening and slipping 8 weeks after operation. The x-ray (C) and CT (F,H) showing the non-union of fracture 12 weeks after operation when the patient first visited our hospital and was started on a subcutaneous injection of teriparatide.
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F1
A 45-year-old male patient sustained a Garden IV fracture of the left femoral neck (Figures 1A,D) caused by a fall and underwent cannulated hip screw surgery at a local hospital in April 2019. The x-ray (Figure 1B) and CT (Figures 1E,G) still showed bone resorption at the fracture site with internal fixation loosening and slipping 8 weeks after operation. The x-ray (Figure 1C) and CT (Figures 1F,H) images showed poor fracture healing, screw loosening, and slipping.
Radiological images (A, F, K) showing trabeculae bridging through fracture sites and a reduction of the fracture space after 3 months of taking the drug. Representative images of the patient regularly reviewed while taking medication (B, G, L). The x-ray (C) and CT film (H, M) showing the bone healing completely after 6 months of stopping the drug. Representative images of the patient regularly reviewed after drug withdrawal (D, I, N). Internal fixation screws were removed in July 2021 (E, J, O) when the patient returned to normal activity feeling no pain.
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F2
Trabeculae bridging through fracture sites and fracture space reduction were seen on the radiological images (Figures 2A,F,K) after 3 months of the patient taking the drug. X-ray (Figure 2C) and CT film (Figures 2H,M) showed the bone healing completely after 6 months of stopping the drug. The internal fixation screws were removed in July 2021 (Figures 2E,J,O) when the patient returned to normal activity feeling no pain.
The treatment timeline of this patient.
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F3
The treatment timeline of the case is showed in Figure 3.