Perry C R, Perry H M, Burdge R E
Clin Orthop Relat Res. 1984 Jul-Aug(187):193-8.
A 70-year-old woman incurred a stress fracture of the radius following a fracture of the ulna. The patient had osteomalacia secondary to a Billroth II procedure. The primary reasons for the development of osteomalacia following a Billroth II procedure are: decreased transit time through the gut, which causes less Vitamin D and calcium absorption, and bypassing of the duodenum, where calcium absorption is highest. After treatment of the osteomalacia with calcium and Vitamin D, the fracture healed uneventfully. The present case report emphasizes the need to identify and treat diseases associated with fractures. Patients with severe osteomalacia and ulnar shaft fractures should have the forearm immobilized because motion at the fracture site may lead to a stress fracture of the radius.