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Case Report
 
Surgical management for tibial shaft fractures using flexible nailing in adult hypophosphatasia
Jay N. Patel1, Priyal V. Bhagat2, Li Sun1, Juluru Rao1
1RWJBarnabas Health, Jersey City Medical Center, Department of Orthopedic Surgery, 355 Grand St, Jersey City, New Jersey, USA
2Northwell Health, Lenox Hill Hospital, 130 E 77th Street, New York, USA

Article ID: Z01201801CR10874JP
doi: 10.5348/ijcri-201805-CR-10874

Corresponding Author:
Jay N. Patel,
RWJBarnabas Health - Jersey City Medical Center,
Department of Orthopaedic Surgery,
355 Grand St, Jersey City,
07302, USA

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How to cite this article
Patel JN, Bhagat PV, Sun L, Rao J. Surgical management for tibial shaft fractures using flexible nailing in adult hypophosphatasia. Int J Case Rep Images 2018;9(1):38–42.


ABSTRACT

Introduction: Adult hypophosphatasia (HPP) is a rare inheritable metabolic disease affecting primarily the skeletal system resulting in decreased mineralization of bone. Hypophosphatasia has a variable inheritance pattern with the more severe form inherited as autosomal recessive. The diagnosis is based on decreased serum alkaline phosphatase (ALP) and an increased urinary phosphorylethanolamine (PEA). Patients with HPP suffer from multiple fractures, have limited mobility, rely on the use of assistive devices, and have a diminished quality of life.
Case Report: A 47-year-old female was presented with a pathologic tibial shaft fracture that was treated with a flexible nail.
Conclusion: Currently, there are no definitive treatment guidelines for fracture care in adults with HPP. Load sharing devices have been recommended due to their load-sharing properties and the osteoporotic bone quality in affected patients.

Keywords: Adult hypophosphatasia, Flexible nailing, Metabolic syndrome, Tibial shaft fracture, Trauma


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Author Contributions
Jay N. Patel – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Priyal V. Bhagat – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Li Sun – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Juluru Rao – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of Submission
The corresponding author is the guarantor of submission.
Source of Support
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Conflict of Interest
Authors declare no conflict of interest.
Copyright
© 2018 Jay N. Patel et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.