Session Title: Virtual Poster Hall
Session Time: None. Available on demand.
Disclosures: Aniroodh T. Reddy, BA: No financial relationships or conflicts of interest
Case Description: A 34 y/o African American male presented to the hospital after significant spasms from hypocalcemia during dialysis. The severe spasms caused bilateral intertrochanteric hip fractures and a right sided proximal humerus fracture. The patient has a history of hypertensive nephrosclerosis that led to ESRD. The patient developed secondary and tertiary hyperparathyroidism due to ESRD. The patient eventually had his parathyroid gland removed. The patient then developed Hungry Bone Syndrome. In HBS, after the body experiences a decrease of parathyroid hormone from parathyroidectomy, the bones reabsorb calcium from the bloodstream, leading to hypocalcemia. The hypocalcemia led to severe muscle spasms called tetany, which caused his fractures. He had an ORIF of the hip fractures and had his right humerus immobilized. The patient then presented to acute rehabilitation for recovery. The patient was weight bearing as tolerated in the lower extremities and left upper extremity, as he also had a prior osteoporotic fracture, and was non-weight bearing through the right humerus. He was initially unable to perform physical therapy due to excess pain and needed an adjustment in pain medication. After better pain control with opiates, counseling, and spasm dampening by calcium control, he was highly motivated and able to tolerate therapy.
Setting: Acute Rehabilitation Hospital.
Patient: The patient is a 34 y/o African American male with PMH of Hypertensive Nephrosclerosis that led to ESRD. Assessment/
Results: Patient was initially max-to-dependent for ADL’s and mobility. After discharge, he was sent home at Mod I to CGA level. At one month follow up, patient was 100% independent with ADLs and increasing ambulation without the use of a device.
Discussion: The objective of this clinical case report is to show the uniqueness of rehabilitating fractures in patients with ESRD complicated by HBS.
Conclusion: This case highlights that pain control and electrolyte corrections are critical for proper rehabilitation in HBS patients.
Level of Evidence: Level V
To cite this abstract in AMA style:Reddy AT, Kalie B, Teeples M, Farrell S. Rehabilitation of Fractures in Hungry Bone Syndrome: A Case Report [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/rehabilitation-of-fractures-in-hungry-bone-syndrome-a-case-report/. Accessed September 28, 2023.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/rehabilitation-of-fractures-in-hungry-bone-syndrome-a-case-report/