Hypophosphatemic osteomalacia in neck femur fracture: Case series

Abstract

Background: In adult acquired hypophosphatemic osteomalacia is generally associated with Biochemical abnormalities. Aims and Objective: To study Hypophosphatemic Osteomalacia in Neck femur fracture : A case series of 10 patients. Methodology: This was a cross-sectional study carried out in the department of Orthopedics from Aug 2015 to August 2016 in the patients who complained of Bilateral Hip (Groin) Pain and inability to walk were; Clinical, Radiological and all laboratory investigations whenever required were done and patients which were having final diagnosis of hypophosphatemic Osteomalacia in Neck femur fracture were included into the study during the study period. All details of the patients like age, sex and clinical features were noted. The data analysis was done by Excel software for windows 10. Result: In our study we have seen that the majority of the patients were in the age group of 60-70(40%), followed by 50-60 (20%), >70 (20%), 40-50 (10%), 30-40 (10%). The majority of the patients were Female (60%) and Males were 40%. The most common clinical features were Bilateral Hip (Groin) Pain (100%), Inability to walk (90%), Bilateral femur fracture (X-ray) in 30%, Unilateral femur fracture (X-ray ) in that Left was predominant i.e. 50% and Right were 20%. In the laboratory findings the all parameters were apparently normal except high Serum ALP level, low Serum Phosphorus level. Treatment and Outcome: Patient were treated conservatively they advised bed rest and supplementation of Tab. Endocal Forte OD, Protocol Supplement 2tsp with milk BD Adophos Sachet in ½ glass of Water QID, Tab. Rocaltrol (2.5) QID, average Patient were walking without support in an average 2 weeks, Pain decreased and also there is improvement of haematological parameter, X-ray shows signs of healing fracture. Conclusion: Hypophosphatemic Osteomalacia is commonly missed due to nonspecific signs and symptoms, but thorough investigation of blood and radiograph required for non-traumatic hip pain. This is rare condition needs high index of suspicion. This is totally curable by conservative Methods.