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Case Reports in Orthopedics
Volume 2017, Article ID 1675654, 3 pages
Case Report

A Case of an Insufficiency Fracture of the Medial Proximal Tibia Secondary to Osteomalacia Associated with Long-Term Saccharated Ferric Oxide Administration

1Department of Orthopaedic Surgery, Gujo Municipal Hospital, 1261 Shimatani, Hachiman, Gujo, Gifu, Japan
2Department of Orthopaedic Surgery, Sumi Memorial Hospital, 2-1 Shirotori, Gujo, Gifu, Japan

Correspondence should be addressed to Daichi Ishimaru; pj.oc.oohay@3002ihciaduramihsi

Received 7 April 2017; Accepted 4 June 2017; Published 4 July 2017

Academic Editor: Hitesh N. Modi

Copyright © 2017 Daichi Ishimaru and Hiroshi Sumi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This article presents a case of insufficiency fracture of medial proximal tibia caused by long-term administration of saccharated ferric oxide (SFO) in a 77-year-old female. In this case, 2-year administration of SFO for iron deficit anemia induced hypophosphatemic osteomalacia and finally resulted in an insufficiency fracture of medial proximal tibia. Hypophosphatemia and pain due to the insufficiency fracture were recovered promptly by withdrawing SFO administration and rest. This case represented varus deformity of the knee associated with osteoarthritis, which may also cause the insufficiency fracture of medial proximal tibia in addition to osteomalacia due to long-term administration of SFO. Long-term SFO administration should be avoided because of a definitive risk of osteomalacia and fragile fracture.