[Hip fracture due to osteomalacia secondary to celiac disease].

BACKGROUND

Hip fracture in the young patient is uncommon, but it can have devastating consequences. This pathology in the context of minimal trauma obliges us to carry out a study on calcium metabolism to determine the primary cause.

MATERIAL AND

METHODS

We present a clinical case about an 18-year-old male patient who suffered a subcapital fracture of the left hip due to minimal trauma while playing football. The patient was treated urgently by means of closed reduction and internal fixation with two spongy screws. Subsequently, the metabolism study showed a severe vitamin D deficiency (27.1 nmol/L - normal above 75 nmol/L) and high levels of anti-transglutaminase IgA antibodies (2502.40 U/mL). The digestive biopsy confirmed the diagnosis of celiac disease and was treated with a gluten-free diet and calcium and vitamin D supplements.

RESULTS

After two years of follow-up, the patient is pain free, with complete hip mobility. There have been no complications (failure of osteosynthesis, avascular necrosis or pseudoarthrosis) and serum levels of vitamin D as well as IgA antibodies against transglutaminase have normalized.

CONCLUSION

In young patients with low energy trauma fractures, vitamin D deficiency must be considered as a possible etiology and the reason for such osteomalacia, such as celiac disease, must be identified.