Longitudinal bone insufficiency fracture of the tibia in a renal transplant recipient.
We report a case of longitudinal tibial fracture as the first manifestation of bone insufficiency in a 50-year-old patient who had received a renal transplant 12 years earlier. The epidemiological, clinical, and imaging features of these fractures are reviewed. Bone loss occurs in the long term in about half of renal transplant recipients. The main causes are preexisting renal osteodystrophy; glucocorticoid therapy; and hyperparathyroidism, whether residual or secondary to imperfect graft function. The effects of cyclosporine therapy on bone metabolism remain unclear. Identification of patients at very high risk of fracture and available options for early prophylaxis are discussed.
Franco
Michel
M
Nephrology department, Hôpital Pasteur, 30, avenue de la Voie Romaine, 06202 Nice cedex 1, France. nephrologie@chu-nice.fr
Bendini
Jean-Christophe
JC
Blaimont
Aude
A
Albano
Laetitia
L
Cassuto
Elisabeth
E
Jaeger
Philippe
P
D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology; D011183:Postoperative Complications; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000209:etiology*