J Korean Orthop Assoc.  1969 Dec;4(4):19-27. 10.4055/jkoa.1969.4.4.19.

Study on the Change of Ca and P in Serum and 24-Hour-Urine in Relation to Immobilization of Orthopedic Patients

Abstract

Hypercalcemia complicating the treatment of fractures is occasionally seen by the orthopedic surgeon. That this complication can occur in immobilized patients with pre-existing metabolic and bone diseases, such as Pagets disease, hyperparathyroidism, multiple myeloma, and the like is well established. It is less well recognized, however, that hypercalcemia can complicate immobilization in patients with no evidence of pre-existing metabolic and bone diseases. The calcium mobilization from the skeleton following immobilization is reflected clinically hypercalciuria, but significant elevation of serum calcium level does not generally occur in normal persons in complete bed rest or in patients with no pre-existing metabolic or bone diseases who are immobilized in the body cast for treatment of fractures. In order to ascertain the above facts, following experiments were carried out in 24 patients who were immobilized after fracture or operation. In each patient, calcium and phosphate levels in serum and 24-hour urine were determined both before and 20 to 30 days after immobilization. The results obtained are summerized as follows; 1) Calcium levels in both serum and 24-hour urine are increased following immobilization, the mean value being 1.17mg percent and 168. 6mg, respectively, with no concomitant increase of phosphate in serum and 24-hour urine. 2) It is also suggested that the amounts of increase in calcium levels in serum and urine are influenced solely by the extent of immobilization and not dependent upon the presence or abscence of pre-existing bone diseases or age.

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