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The differential diagnosis of a fractured clavicle includes acute traumatic fracture, stress fracture, pathologic fracture secondary to radiation exposure, neoplasm, infection, or metabolic bone disease, and fracture-like conditions such as infection and bony dysplasias. An appropriate workup should identify most of these underlying conditions. We report a case of concurrent bilateral nontraumatic fractures of the clavicle occurring in a healthy young man in the absence of repetitive trauma. Workup revealed no underlying explanation for the fractures. To our knowledge, this has not been reported. Our case suggests the differential diagnosis of a fractured clavicle should be expanded to include idiopathic nontraumatic fractures.

An observational cohort study was performed on 90 hip arthroplasties performed in 84 patients for metastatic disease of the hip. Significant improvement was noted with both 3-month and 6-month function scores vs preoperative function scores (P < .001). Complications included 1 intraoperative femur fracture, 2 cases of deep venous thrombosis, 1 peroneal nerve palsy, 1 deep infection, and 5 dislocations. Eight (8.8% of 90 procedures, 9.4% of 84 patients) patients died during the initial hospital stay. Although the risk of mortality after hip arthroplasty for metastatic diseases is perhaps higher than previously expected, improvement in postoperative function scores in surviving patients was significant and perioperative morbidity in this complex patient population was acceptably low.