Bilateral Olecranon and Left Lesser Trochanter Avulsion Fractures in Renal Osteodystrophy: A Rare Case Report and Comprehensive Review
Case studies
Vijay RK Papineni
Sheikh Shakhbout Medical City image/svg+xml
Rajesh Botchu
Royal Orthopaedic Hospital image/svg+xml
Kartikeyan P. Iyengar
Southport and Ormskirk Hospital NHS Trust image/svg+xml
https://orcid.org/0000-0002-4379-1266
Shashank Chapala
Asian Institute of Gastroenterology image/svg+xml
https://orcid.org/0009-0007-2956-0270
Asad Rabbani Shah
Sheikh Shakhbout Medical City image/svg+xml
Balamurugan Rathinavelu
Sheikh Shakhbout Medical City image/svg+xml
Published 2025-07-29
https://doi.org/10.15388/Amed.2025.32.2.1
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Keywords

avulsion fractures
femur
olecranon process
Chronic Kidney Disease-Mineral and Bone Disorder
radiography
ultrasonography
Magnetic Resonance Imaging

How to Cite

1.
Papineni V, Botchu R, Iyengar KP, Chapala S, Shah AR, Rathinavelu B. Bilateral Olecranon and Left Lesser Trochanter Avulsion Fractures in Renal Osteodystrophy: A Rare Case Report and Comprehensive Review. AML [Internet]. 2025 Jul. 29 [cited 2025 Jul. 31];32(2):1. Available from: https://www.zurnalai.vu.lt/AML/article/view/38859

Abstract

Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) disrupts phosphorus and calcium metabolism, leading to skeletal disorders such as demineralization, weakened bones, and an increased fracture risk. These disorders, known as renal osteodystrophy, vary widely and are classified into secondary hyperparathyroidism, adynamic bone, and osteomalacia based on bone turnover. Fracture risk increases with the severity of CKD, particularly in advanced stages (creatinine clearance <15–20 mL/min), but even patients with mild to moderate CKD are at risk of fractures. Fractures of the Lesser Trochanter (LT) in adults are rare, and most are caused by underlying malignancies. We present a case of simultaneous avulsion fractures in the left lesser trochanter and bilateral olecranon processes secondary to minor trauma in a young patient with End Stage Renal Disease, which has not been previously reported, and review the literature. This review summarizes the role of imaging (Radiography, US, Computed Tomography, and Magnetic Resonance Imaging) in assessing avulsion fractures in patients with end-stage renal disease. Ultrasound serves as a supportive tool in evaluating the neuromusculoskeletal system; however, in patients with end-stage renal disease, radiography, CT, and MRI remain the primary imaging modalities for assessing avulsion fractures.

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