Lin TC, Lin SW, Yeh KT. Parathyroidectomy restored bone mineral density in a neglected femoral neck fracture with renal osteodystrophy: A case report. World J Clin Cases 2024; 12(25): 5761-5768 [PMID: 39247751 DOI: 10.12998/wjcc.v12.i25.5761]
Corresponding Author of This Article
Kuang-Ting Yeh, MD, PhD, Associate Chief Physician, Associate Professor, Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707 Chung-Yang Road, Hualien 970473, Taiwan Province, China. micrograft@tzuchi.com.tw
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2024; 12(25): 5761-5768 Published online Sep 6, 2024. doi: 10.12998/wjcc.v12.i25.5761
Parathyroidectomy restored bone mineral density in a neglected femoral neck fracture with renal osteodystrophy: A case report
Tzu-Ching Lin, Shih-Wei Lin, Kuang-Ting Yeh
Tzu-Ching Lin, Kuang-Ting Yeh, Department of Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan Province, China
Shih-Wei Lin, Department of Orthopedics, Ten-Chan Medical Group, Taoyuan 320003, Taiwan Province, China
Kuang-Ting Yeh, Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan Province, China
Kuang-Ting Yeh, Department of Graduate Institute of Clinical Pharmacy, Tzu Chi University, Hualien 970374, Taiwan Province, China
Author contributions: Lin TC was responsible for writing manuscript; Lin SW was responsible for conceptualization, methodology, and data curation; Yeh KT was responsible for review and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from all subjects prior to any study procedure. The study was conducted following the Declaration of Helsinki and approved by the Medical Ethics Committee of Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (No. IRB112-228-B; date of approval: 2023/11/08).
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kuang-Ting Yeh, MD, PhD, Associate Chief Physician, Associate Professor, Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707 Chung-Yang Road, Hualien 970473, Taiwan Province, China. micrograft@tzuchi.com.tw
Received: January 2, 2024 Revised: June 11, 2024 Accepted: July 3, 2024 Published online: September 6, 2024 Processing time: 197 Days and 2.5 Hours
Abstract
BACKGROUND
This case report contributes to the medical literature by highlighting the successful management of a neglected femoral neck fracture in a patient with renal osteodystrophy and secondary hyperparathyroidism (SHPTH) who was on dialysis due to end-stage renal disease (ESRD). It underscores the efficacy of parathyroidectomy (PTX) in restoring bone mineral density (BMD) and promoting fracture healing, addressing a significant complication in ESRD patients.
CASE SUMMARY
A 36-year-old female with renal osteodystrophy and on dialysis due to ESRD presented with a history of left patellar tendon rupture and later, a right achilles tendon avulsion fracture. Persistent right hip pain led to the discovery of a neglected right femoral neck fracture, which was initially overlooked due to the patient’s complex medical history. Two months post-achilles tendon repair, the patient underwent PTX to manage the refractory SHPTH. The postoperative course included rehabilitation and weight-bearing exercises. Remarkably, 2 years after osteosynthesis, radiographic assessments indicated a solid union of the periprothesis fracture and significant improvement in BMD, showcasing the efficacy of the treatment approach.
CONCLUSION
PTX, combined with appropriate rehabilitation, is crucial for improving BMD and fracture healing in ESRD patients with SHPTH.
Core Tip: This case report illustrates the successful treatment of a neglected femoral neck fracture in a patient with renal osteodystrophy and secondary hyperparathyroidism (SHPTH). The patient, suffering from end-stage renal disease (ESRD) on dialysis, experienced significant improvement in bone mineral density and fracture healing post-parathyroidectomy. This intervention, along with tailored rehabilitation and weight-bearing exercises, highlights the importance of managing SHPTH in ESRD patients to enhance bone health and reduce fracture risks. This multidisciplinary approach demonstrates a vital strategy for improving outcomes for patients with complex skeletal disorders associated with chronic kidney disease.
