Neck of Femur Fracture in Young Patients With End-Stage Renal Disease and Hyperparathyroidism: A Report of Three Cases and Proposed Treatment Algorithm

Abstract

Secondary hyperparathyroidism is a complication arising from untreated end-stage renal disease (ESRD). It can invariably lead to osteoporosis and subsequently cause pathological neck of femur (NOF) fracture. Despite being young, osteosynthesis in neck of femur fractures of these patients often leads to nonunion and implant failure due to severely osteoporotic bone. We present our experience in managing three young patients with ESRD and secondary hyperthyroidism who sustained NOF fractures. All three patients were successfully treated and showed no complication at one year post-operation. Based on our experience and literature review, we propose a simple algorithm to guide the management of these patients.

Outcomes of Geriatric Hip Fractures in a Tertiary Referral Center in Malaysia During the COVID-19 Pandemic

“…Fragility fractures are fractures that occur as a result of mechanical forces that would not typically cause a fracture [1][2][3][4][5]. The most common fragility fractures are hip fractures in elderly patients.…”

“…As the population ages, the incidence of osteoporosis also increases accordingly [1][2][3][4]. One of the clinical manifestations of osteoporosis is hip fracture [1][2][3][4][5]. With the enhancement of surgical knowledge and advancements in implant materials, effective and proven surgical interventions such as total hip arthroplasty, hemiarthroplasty and implant fixation are available to manage patients with geriatric hip fractures [6][7][8][9][10][11][12].…”

“…However, due to the fact that all the patients involved are elderly with multiple comorbidities, patients with geriatric hip fractures are prone to numerous complications such as thromboembolism, infection, gastrointestinal bleeding, delirium and functional loss [10][11][12][13][14][15][16][17]. Approximately 25% of older patients who sustain hip fractures die within one year, and about 13% die within six months after the trauma [5][6][7][8][9][10][11][12][13][14][15][16][17]. The recovery rate among those who survived is also poor, with only up to 50% of the patients regaining their ability to perform activities of daily living as prior to the fracture [15][16][17][18][19][20][21][22].…”

Robotic-Assisted Hip and Knee Arthroplasty: A Bibliometric Analysis Using the Scopus Database

“…With the advancement of technology and healthcare systems, the proportion of the world's population over 60 years old is estimated to be 22% [1][2][3]. As the population ages, the incidence of degenerative joint diseases also increases accordingly [4][5][6][7]. As a result, the demand for restorative surgeries, such as knee and hip replacements, is projected to rise in tandem with the increasing prevalence of patients with hip and knee osteoarthritis [7][8][9].…”

“…As the population ages, the incidence of degenerative joint diseases also increases accordingly [4][5][6][7]. As a result, the demand for restorative surgeries, such as knee and hip replacements, is projected to rise in tandem with the increasing prevalence of patients with hip and knee osteoarthritis [7][8][9]. In 2010, an estimated 2.5 million people underwent total hip replacement, while 4.7 million people underwent total knee replacement (TKR) in the United States of America (USA) [7,8].…”