Femoral neck fracture in a senile patient with primary hyperparathyroidism: A case report

Rationale:As a rare cause of femoral neck fracture, usually, hyperparathyroidism is missed diagnosed by orthopedist. Patient can present with various disappearance of clinical manifestations. Primary hyperparathyroidism in senile male population is commonly an asymptomatic disorder discovered incidentally through routine lab testing. Here, this study reports a case of femoral neck fracture in a senile patient with primary hyperparathyroidism.Patients concerns:A 70-year-old male patient with a known right femoral neck fracture associated with primary hyperparathyroidism.Diagnoses:A neck ultrasound (US) and computed tomography revealed a solid mass below the right lobe of the thyroid. X-ray plain and computed tomography confirmed right femoral neck fracture and multiple bone lesions. The routine lab testing showed hypercalcemia and hyperkalemia.Interventions:Before undergoing total hip arthroplasty surgery, patient was temporarily treated with hydration, diuretics, and calcitonin. Besides, the patient underwent parathyroidectomy of the enlarged parathyroid gland. Oral calcium preparations were routinely used for prevention of hypocalcemia.Outcomes:After completing all surgery, the patient was discharged without any complications including hypercalcemia and hyperkalemia.Lessons:Femoral neck fracture associated with primary hyperparathyroidism is a rare presentation. This case highlights that hypercalcemia and multiple osteopathy should be considered in the differential diagnosis in patients with pathological fracture caused by micro-traumatic injury.