title: Nontraumatic central fracture dislocation of the hip in a patient with chronic kidney disease and post gastrectomy.
abstract: OBJECTIVE
  PATIENTs with secondary hyperparathyroidism caused by chronic kidney disease (CKD) develop secondary osteoporosis, which increases fracture risk. We report a case of insufficiency fractures complicated by secondary osteoporosis caused by chronic renal failure and gastrectomy.
  
  
  METHODS
  A 78-year-old man with a medical history of nephrotic syndrome and gastric cancer experienced an occult intertrochanteric fracture of his left femur after falling.
  
  
  RESULTS
  Ten days after the first fracture, the patient was treated with hemodialysis for acute uremic symptoms. Eight weeks after this fracture, he sustained a right insufficiency acetabular fracture and was treated with total hip arthroplasty (THA).
  
  
  CONCLUSIONS
  For patients with CKD, effective fracture prevention is difficult. THA with reconstruction of the acetabulum was an effective therapy in a patient with nontraumatic central fracture dislocation of the hip.
authors.affiliation: Department of Orthopedic Surgery, Namegata District General Hospital, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Department of Orthopedic Surgery, Namegata District General Hospital, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Kameda
authors.affiliation: Department of Orthopedic Surgery, Ryugasaki Saiseikai Hospital, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Kawamura
authors.affiliation: Department of Orthopedic Surgery, Namegata District General Hospital, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Makihara
authors.affiliation: Department of Orthopedic Surgery, Ibaraki Prefectural University of Health Sciences, Japan.
authors.forename: Yukiyo
authors.initials: Y
authors.lastname: Shimizu
keywords: central fracture dislocation of the hip; chronic kidney disease; insufficiency fracture; secondary hyperparathyroidism