Insufficiency Fracture of the Proximal Femur in a Spastic Paraplegic Patient: A Case Report.

Managing lower extremity insufficiency fractures in patients with severe spastic paraplegia presents unique challenges. These fractures occur without significant trauma due to factors such as decreased bone quality and reduced muscle mass. The optimal treatment approach remains unclear due to the rarity of reported cases in the literature. This case report describes a severely displaced proximal femur fracture in a 33-year-old male with severe spastic paraplegia, mimicking a posterior hip dislocation deformity. The fracture was successfully treated with open reduction and internal fixation using a static intramedullary nail. This case underscores the importance of individualized treatment strategies for complex fractures in patients with spinal cord injuries and severe spastic paraplegia.