Low-energy hip fracture in a socially withdrawn and physically inactive teenager highlighting the age-independent role of mechanical loading and nutrition: a case report
Abstract
Background: Proximal femur fractures in adolescents are rare and usually occur following high-energy trauma. When such injuries result from minimal trauma, they demand careful evaluation of skeletal integrity. This case highlights how social withdrawal, prolonged immobilization, and malnutrition can lead to reversible bone fragility and an unusual fracture pattern in a young patient.
Case presentation: A 14-year-old boy of Danish ethnicity with no prior somatic disease sustained an intertrochanteric femur fracture after falling from a floor bed of approximately one meter. For the preceding two years, he had been socially withdrawn and largely bedridden. Profound malnutrition, vitamin D deficiency, secondary hyperparathyroidism, and markedly reduced bone quality were evident. Intraoperative findings confirmed cortical thinning and brittle bone structure inconsistent with chronological age. The patient was treated with surgical fracture fixation using a pediatric dynamic hip screw in combination with vitamin D and calcium supplementation, calorie-dense nutrition, physiotherapy, and social support. The fracture healed, and over eight months he regained mobility, caught up on body weight and growth, and improved in developmental parameters.
Conclusions: Low-energy hip fractures in adolescents are rare but may indicate reversible bone fragility from unloading and malnutrition; early multidisciplinary interventions are warranted.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.