{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:51:30Z","timestamp":1757613090623,"version":"3.44.0"},"reference-count":5,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2024,12,2]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>We describe a woman with stiff-person syndrome (SPS), whose muscle spasms resulted in sequential bilateral femoral neck fractures. Orthopaedic fixation of the first fracture was complicated by increased muscle spasm, fracture nonunion and ultimately metalwork fracture. SPS was diagnosed following the fracture of the contralateral femoral neck, neurology assessment and detection of high-titre antibodies to glutamic acid decarboxylase. Multidisciplinary management with high-dose benzodiazepines, intravenous immunoglobulin infusions, and bilateral total hip replacements achieved a good functional outcome. Spasms associated with SPS are a rare cause of pathological fractures and may cause orthopaedic fixation to fail. Early recognition and multidisciplinary care are essential to prevent additional morbidity.<\/jats:p>","DOI":"10.1136\/pn-2024-004391","type":"journal-article","created":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T13:20:19Z","timestamp":1735132819000},"page":"356-358","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Bilateral femoral neck fractures and fixation failure due to stiff-person syndrome"],"prefix":"10.1136","volume":"25","author":[{"given":"Daniel","family":"Whittam","sequence":"first","affiliation":[{"name":"Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, UK"},{"name":"Neurology Department, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Helm","sequence":"additional","affiliation":[{"name":"Trauma and Orthopaedics Department, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry","family":"Tucker","sequence":"additional","affiliation":[{"name":"Neurology Department, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,25]]},"reference":[{"key":"2025090410165744000_25.4.356.1","doi-asserted-by":"crossref","unstructured":"Bose S , Jacob S . Stiff-person syndrome. Pract Neurol 2024;0. doi:10.1136\/pn-2023-003974","DOI":"10.1136\/pn-2023-003974"},{"key":"2025090410165744000_25.4.356.2","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.CC.18.00049","article-title":"Femur Neck Fracture in a Patient with Stiff Person Syndrome: A Case Report","volume":"9","author":"Jamil","year":"2019","journal-title":"JBJS Case Connect"},{"key":"2025090410165744000_25.4.356.3","doi-asserted-by":"crossref","first-page":"S237","DOI":"10.1016\/j.pmrj.2016.07.271","article-title":"Poster 237 Bilateral Hip Fracture During Hospitalization for Spasm Exacerbation in an Adult with Stiff Person Syndrome: A Case Report","volume":"8","author":"Podobinski","year":"2016","journal-title":"PM R"},{"key":"2025090410165744000_25.4.356.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5065.265"},{"key":"2025090410165744000_25.4.356.5","doi-asserted-by":"crossref","DOI":"10.1212\/NXI.0000000000200109","article-title":"Therapies in Stiff-Person Syndrome: Advances and Future Prospects Based on Disease Pathophysiology","volume":"10","author":"Dalakas","year":"2023","journal-title":"Neurol Neuroimmunol Neuroinflamm"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/pn-2024-004391","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T17:17:09Z","timestamp":1757006229000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/pn-2024-004391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,25]]},"references-count":5,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,7,14]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/pn-2024-004391"],"URL":"https:\/\/doi.org\/10.1136\/pn-2024-004391","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"type":"print","value":"1474-7758"},{"type":"electronic","value":"1474-7766"}],"subject":[],"published":{"date-parts":[[2024,12,25]]}}}