Diagnosis and treatment of pathologic fracture caused by primary hyperparathyroidism
Qi Yubin1,Li Dong2,Ma Huanzhi2
1Department of Orthopedics,Qianfoshan Hospital Affiliated to Shangdong University,Jinan 250014,China;2Department of Bone Tumour,Shandong Provincial Hospital Affiliated to Shandong University,Jinan 250021,China
Abstract：ObjectiveTo explore the early diagnosis and improve the treatment of primary hyperparathyroidism.MethodsFive patients of pathological fracture caused by primary hyperparathyroidism (PHPT)，who admitted to Shandong Provincial Hospital in recent 3 years were enrolled in this study.ResultsDistensible bone destruction was found by imageological examination in 5 patients,the other 2 cases were bone cyst and aneurysmal bone cyst respectively.Four patients with preoperative test indicators of typical hypercalcemia,hypophosphatemia,and the levels of alkaline phosphatase and PTH were significantly increased.The diagnosis of PHPT was further diagnosed by neck ultrasonography and parathyroid 99mTc-MIBI examination.Parathyroid gland surgery was performed in 3 cases,postoperative pathology was parathyroid adenoma,and 2 cases were transferred to the department of endocrinology for symptomatic treatment.Five patients were followed up for 6 to 24 months,and sclerotin of all patients had been repaired with different degree,callus growth was continuous.ConclusionsThe simultaneous increase of serum calcium and PTH is an important basis for the diagnosis of PHPT.Early detection of serum calcium,phosphorus and PTH,parathyroid ultrasonography and 99mTcMIBI can diagnose PHPT early and can improve the cure rate.
