Abstract
INTRODUCTION AND IMPORTANCE: Simultaneous bilateral femoral neck fractures are rare and challenging, often occurring due to high-energy trauma in younger adults or low-energy trauma compounded by metabolic issues in elderly populations. Neglected cases, particularly in the context of narcotic addiction and limited access to healthcare, present unique management dilemmas. This study aims to contribute insights into the clinical presentation, management strategies, and outcomes of two neglected simultaneous bilateral femoral neck fractures. CASE PRESENTATION: We present two cases: a 65-year-old woman and a 45-year-old man, both with a history of narcotic addiction, who presented with neglected simultaneous bilateral femoral neck fractures. Both cases demonstrated significant pain and functional impairment necessitating surgical intervention. CLINICAL DISCUSSION: Treatment involved one-stage bilateral hip hemiarthroplasty, which successfully restored function without postoperative complications during follow-up periods of 14 and 16 months. Discussion includes the challenges of diagnosing and managing neglected fractures in vulnerable populations, emphasizing the importance of early recognition and tailored surgical approaches. CONCLUSION: Our study suggests the efficacy of one-stage bilateral hip hemiarthroplasty in managing neglected simultaneous bilateral femoral neck fractures due to narcotic addiction. However, variability in outcomes across different surgical techniques highlights the need for individualized treatment plans based on patient-specific factors.