Delayed Presentation of Femoral Neck Fracture in Neurolathyrism: A Case Report

Abstract

Fragility fractures of the femoral neck in young adults are uncommon. Neurolathyrism has been linked to pathological
fractures, but femoral neck involvement has not been specifically described. We report a low-energy femoral neck fracture
in a patient with longstanding neurolathyrism who was managed with a valgus intertrochanteric osteotomy. The pathways
through which neurolathyrism increases fracture susceptibility remain poorly understood. Possible contributors include
reduced mobility and abnormal loading from spastic paraparesis and direct toxin-related effects of Lathyrus sativus on bone
structure and osteoblastic function. This report presents the case and reviews the literature to summarize biological and
mechanical factors that may increase fracture risk in this population.