A CASE OF PATHOLOGICAL FRACTURE OF SHAFT OF FEMUR IN HYPERPARATHYROIDISM - TREATMENT WITH TITANIUM ELASTIC NAILING

Dr K. Sundaresh1, Dr Abhishek Gumaste2* Dr Pramod G3, Dr Rajeevratna Suresh Naik Dr Salahuddin Qualid M D5

Dr K. Sundaresh1, Dr Abhishek Gumaste2* Dr Pramod G3, Dr Rajeevratna Suresh Naik Dr Salahuddin Qualid M D5 1 Associate Professor, Department of Orthopaedics, Vijayanagar Institute of Medical Sciences, Bellary, Karnataka, India 2 Junior Resident, Department of Orthopaedics, Vijayanagar Institute of Medical Sciences, Bellary, Karnataka, India 3 Junior Resident, Department of Orthopaedics, Vijayanagar Institute of Medical Sciences, Bellary, Karnataka, India 4 Junior Resident, Department of Orthopaedics, Vijayanagar Institute of Medical Sciences, Bellary, Karnataka, India 5 Junior Resident, Department of Orthopaedics, Vijayanagar Institute of Medical Sciences, Bellary, Karnataka, India

Abstract

Primary hyperparathyroidism is associated with a significant increase in the risk of pathological fractures. Persistent osteopenia secondary to increased calcium mobilisation from bones makes these patients highly susceptible to multiple fractures. Some authors report only partial correction of bone loss after surgery, such correction occurring only in the first year with restoration of trabecular bone but not cortical bone.⁽¹⁾Some authors conclude that fractures in PHPT take longer to heal and are prone to malunion unless splinted internally or externally.⁽²⁾ We present a case of pathological fracture of femur shaft in a patient with PHPT with superadded vitamin D deficiency, which healed adequately in a span of 6 weeks, after fixation with titanium elastic nails and oral Vitamin D supplementation. The rapidity and the normalcy of bony union in a case of pathological long bone fracture, secondary to primary hyperparathyroidism, makes this case worth reporting.

Key words: PHPT-primary hyperparathyroidism, pathological fracture.