A Neglected Case of Bilateral Hip Fractures and Other Fractures with Delayed Diagnosis of Hyperparathyroidism as Cause

Vol 4 | Issue 2 | May – Aug 2018 | page: 34-37 | Sanjay Chhawra, Arun Kumar N Kambar, Ravi Gupta


Author: Sanjay Chhawra [1], Arun Kumar N Kambar [1], Ravi Gupta [1].

[1] Department of Orthopaedics, Jaipur Golden Hospital , 2 Institutional Area ,Sec 3 Rohini Delhi 110085.

Address of Correspondence
Dr. Sanjay Chhawra
A-144 Gaytri Vihar Bagh Mughaliya, Bhopal. MP. India.
E-mail: sanjaychhawra@yahoo.com


Abstract

Introduction: Primary hyperparathyroidism is a disease characterized by hypercalcemia attributable to autonomous overproduction of PTH ParaThyroid Hormone.Primary hyperparathyroidism PHPT is prevalent in approximately 1% of adult population with F;M 3;1. The disease affects multiple systems –Musculosketal, CVS, G.Urinary, Abdomen and Endocrine. Primary hyperparathyroidism present with classic signs and symptoms of hypercalcaemia. Non-specific symptoms may include muscle weakness, thirst, polyuria, anorexia and weight loss along with pathological fractures.The treatment of choice is parathroidectomy after proper investigation.
Case Report: A 40 yrs Male presented with Pain, Swelling and Deformity over Bilateral Hip, Right Shoulder, Right Hand and Right Clavicular Region. Unable to bear weight since 1 year. Along with its General Complaint of Weakness, Joint Pain, Abdominal Pain with clinical syptoms and operated right sided hip after proper investigation patient was diagnosed Hyperparathyridism with B/L Hip fracture {unusual presentation }multiple fractures with implant failure .After Parathyroidectomy and regular follow fracture fixation was done later with calcium supplementation the outcome was satisfactory.
Conclusions: Repeatedly multiple fractures must be investigated with appropriate and precise routine serum biochemical along with PTH Vitamin D Thyroid profile to diagnose endocrine disorder as in this case diagnosed as Hyperparathyroidism.With Clinical examination of neck as specific site with extremities, deformities and systemic examination is essential. USG Neck as routine investigation for this disease. After parathyroidectomy and regular follow up is done. Afterwards fracture fixation is done as secondary procedure with adequate calcium and vitamin D correction give good prognosis better union with best possible outcome. This is rare presentation of PHPT with B/L Hip fracture and other fractures deformities is an excellent example of an endocrine disease that is best managed by a multidisciplinary approach and long term patient follow up.
Keywords: Primary Hyperparathroidism PHPT, Pathological fracture, PTH Parathyroid Hormone.


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How to Cite this article:  Chhawra S, Kambar AN, Gupta R. A Neglected Case of Bilateral Hip Fractures and Other Fractures with Delayed Diagnosis of Hyperparathyroidism as Cause. Trauma International May – Aug 2018;5(2):34-37.


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