Primary hyperparathyroidism with extensive brown tumours and distal humerus fracture—A case report

Bone disease is an important complication of hyperparathyroidism. We herein report a rare case of severe bone disease caused by primary hyperparathyroidism. A 33-year-old man presented with pain and restricted mobility in his right upper limb and right hip due to a fall 3 days previously. X-ray examination showed a fracture of the proximal and distal humerus. Computed tomography examination showed a supracondylar fracture of the right humerus, a fracture of the right femoral neck, a fracture of the right sciatic branch, and multiple brown tumors. Ultrasonography showed a 3.5- × 1.6-cm hypoechoic mass below the left lobe of the thyroid. The patient was diagnosed with primary hyperparathyroidism based on increased serum calcium and parathormone concentrations, pathological fractures, and multiple brown tumors. He therefore underwent bilateral lower parathyroidectomy. Pathological examination revealed a parathyroid adenoma. The patient recovered well after surgery and was followed up for 6 months with no symptoms of hyperparathyroidism. This case report suggests that clinicians should be aware of the possibility of severe bone disease secondary to primary hyperparathyroidism. Active and early diagnosis and surgical treatment are important in such cases.

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Treatment of Elderly Distal Humerus Fracture Using LCP-Distal Humerus Plate

Orthopedics & Traumatology ◽

10.5035/nishiseisai.59.523 ◽

2010 ◽

Vol 59 (3) ◽

pp. 523-527 ◽

Cited By ~ 1

Author(s):

Haruhiko Chuma ◽

Kazutoshi Nomura ◽

Noburo Hashimoto ◽

Tetsuya Fukumoto ◽

Satoshi Maeda ◽

...

Keyword(s):

Distal Humerus ◽

Humerus Fracture ◽

Distal Humerus Fracture

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STUDY OF THE FUNCTIONAL OUTCOME OF SURGICAL MANAGEMENT OF INTRA-ARTICULAR DISTAL HUMERUS FRACTURE (AO/OTA TYPE C) IN ADULTS

10.36106/ijsr/0809423 ◽

2020 ◽

pp. 1-3

Author(s):

Ravindra Prasad ◽

L B Manjhi

Keyword(s):

Internal Fixation ◽

Range Of Motion ◽

Functional Outcome ◽

Surgical Management ◽

Distal Humerus ◽

Humerus Fracture ◽

Joint Surface ◽

Distal Humerus Fracture ◽

Complex Anatomy ◽

Type C

Introduction: Distal humerus fracture in adults particularly complete articular (AO/OTA Type C) remain some of the most difficult injuries to manage. Complex anatomy of distal humerus combined with multifragmented fracture, sparse soft tissue cover with adjacent neurovascular structures poses great difficulty for treatment. Goal of treatment is to obtain a painless, stable and mobile elbow joint through a systematic approach. Aim: to study the functional outcome of surgical management of complete articular distal humerus fracture in adults. Method: a prospective study comprising of 20 patients treated surgically with open reduction and internal fixation using Orthogonal plating (dorsolateral and medial 3.5mm LCP) through trans olecranon approach. Result: Mean age of patients was 36.6 years (range 19 to 58 years) with male dominance, most fractures were of type 13C1 (AO/OTA). RTA accounts for most common mode of injury, majority of them being left sided. Mean operative time was 130 minutes. Complications included one case of superficial infection, 3 cases of ulnar neuropathy and non-union in 2 cases. Mean range of motion of elbow was 89 degree. Functional outcome assessed using Mayo Elbow Performance Score (MEPS) shown Excellent result in 12 cases, good to fair results in 6 and poor result in 2 cases. Conclusion: Anatomical restoration of joint surface and rigid internal fixation with bicolumnar orthogonal plating allowing early range of motion is the key for obtaining good functional results in complete articular distal humerus fractures. However, outcomes do deteriorate with increasing fracture complexity.

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