Subtrochanteric Femur Fracture in Monostotic Pagets Disease and its Management – A Case Report and Review of Literature

Introduction: Paget disease of bone is a chronic progressive disease of the bone of uncertain etiology, characterized initially by an increase in bone resorption, followed by a disorganized and excessive formation of bone, leading to pain, fractures, and deformities. It can manifest as a monostotic or polyostotic disease. Pathological fracture secondary to Paget’s disease requires surgical management. Case Report: A 60-year-old male patient came with complaint of pain and swelling over the left hip for 30 days. The patient had a history of a trivial fall. Radiological investigations were suggestive of pathological subtrochanteric femur fracture with Paget’s disease of the left femur. We managed with the long proximal femoral nail (PFN). Histopathological examination confirmed the diagnosis of Paget’s disease. At present 1-year follow-up, the patient is having good radiological and functional outcome with no implant failure. Conclusion: Subtrochanteric pathological femur fractures in Paget’s disease are best managed with the long PFN with good outcome and fewer complications, which help in early mobilization and weight-bearing. Long PFN spans the entire pathologic femur and prevents the secondary fractures. Keywords: Pagets disease, femur subtrochanteric fracture, long proximal femur nail.