Multiple fractures in a 22 year old man after a simple fall

3^rd Global Experts Meeting on Medical Case Reports

May 09-10, 2016 New Orleans, USA

Mohammed Hashem Alattas

Security Forces Hospital, Kingdom of Saudi Arabia

Posters & Accepted Abstracts: J Clin Case Rep

Abstract :

We present the case of a 22 year old male with longstanding progressive fatigue, weakness and pain around his hips due to an undiagnosed parathyroid adenoma. The resultant primary hyperparathyroidism ultimately caused pathologic fractures. He was admitted to the hospital for further assessment and excision of the parathyroid adenoma. A few days after admission, he fell down while walking and was referred to our team. X-rays showed a displaced left femoral neck fracture (FNF) and right humeral shaft fracture with poor bone quality. His humeral fracture was treated conservatively and the FNF was treated with total hip replacement (THR). Three days later, he underwent parathyroidectomy. Within 3 days postoperatively, the parathyroid hormone level had decreased to 4.9 pmol per liter and the calcium level had returned to normal at 2.42 mmol per liter. We believe that, despite the young age of our patient, THR was still the preferred treatment in this situation owing to his poor bone quality, which could have led to failure of fixation; in addition, severe fracture displacement carries a high risk of femoral head avascular necrosis. Yang et al. found that salvage THA for failed internal fixation following FNF is a more technically demanding procedure with prolonged operative time and larger amounts of postoperative drainage (within 24 hours) and that patients are at increased risk of developing hip complications compared with primary THR for acute displaced FNF. This case demonstrates the importance of a thorough investigation of progressive weakness even in a young individual and illustrates the importance of early diagnosis of parathyroid adenoma to avoid the devastating end results of this condition.

Biography :

Email: dr_mohdh1400@hotmail.com