Immobilization Hypercalcemia After Single Limb Fractures in Children and Adolescents

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Abstract
• Immobilization hypercalcemia following a single limb fracture of one weight bearing bone has been reported rarely in the pediatric age group. Nevertheless, in six of 12 patients immobilization hypercalcemia developed, associated with elevations in the urinary calcium/creatinine ratio and serum levels of ionized calcium after a single limb fracture of a weight-bearing bone during this two-year study period. We suggest that immobilization hypercalcemia occurs frequently in both children and adolescents after a single limb fracture of one weight-bearing bone, exercises in bed fail to prevent immobilization hypercalcemia, serial measurements of the serum ionized calcium and the urinary calcium/creatinine ratio are critical measures in treating such patients, and though complete mobilization is curative, transient calcitonin therapy is highly effective in reversing the disorders in calcium metabolism. (Am J Dis Child 132:560-564, 1978)