A simultaneous bilateral asymmetric hip fracture in an elder
-Simultaneous bilateral hip fractures in the elderly are rare and usually have a symmetric pattern.
-Intracapsular fractures on one side and trochanteric on the other are even rarer.
-They are caused by a spontaneous fracture which causes a fall on the contralateral side.
-The trochanteric fracture should be operated first to avoid possible complications.

Simultaneous bilateral hip fractures are usually associated with high energy trauma, seizures, metabolic diseases and bisphosphonates use. They are observed rarely in the elderly population after simple trauma and usually have the same fracture pattern (symmetric).

86-year old woman with a simultaneous bilateral asymmetric hip fracture (trochanteric on the right side and subcapital on the left), occurred after a fall at home. The patient was surgically treated by open reduction and internal fixation with an intramedullary nail on the right and by hemiarthroplasty on the left performed during the same surgical session, with good results.

Simultaneous bilateral hip fractures in the elderly are rare and usually are symmetric. In the majority of the cases, these fractures are intracapsular and are treated by hemiarthroplasties. On the contrary, simultaneous bilateral hip fractures with a different pattern, as the described case, are extremely rare. The possible mechanism of injury is a spontaneous fracture on one side, which causes a fall the contralateral side. The surgical treatment may be performed bilaterally, treating first the trochanteric fracture. Simultaneous bilateral asymmetric hip fractures are extremely rare and may occur in elderly patients with a specific mechanism of injury.

Source: https://www.sciencedirect.com/science/article/pii/S221026122030434X?dgcid=rss_sd_all