PRIMARY HYPERPARATHYROIDISM PRESENTING AS MULTIPLE PATHOLOGICAL FRACTUTES

Primary hyperparathyroidism often was not diagnosed until patients develop symptoms and signs of advanced disease. The prevalence rate varies from 1 to 4 percentage. Elevated PTH levels cause bone resorption, formation of polyostotic lesions and reduction in bone mineral density predisposing to pathological fractures. We had a case of primary hyperparathyroidism with fracture neck of humerus, fracture neck of femur and supracodylar fracture femur following trivial trauma. The patient also had left superior parathyroid adenoma with elevated parathyroid hormone and alkaline phosphatase. She was treated with percutaneous screw fixation for neck of humerus fracture and neck of femur fracture with plating for supracondylar femur fracture. Enucleation of left superior parathyroid adenoma was done followed by calcium and vitamin D supplementation. During follow up period the patient had good fracture union, improvement in bone density and good functional outcome .