Corrective osteotomy in femoral non-union in drug-induced hypophosphataemic osteomalacia

Adefovir/tenofovir are commonly used antiviral agents in the treatment of chronic hepatitis B infection (CHB). We report a case of CHB-related cirrhosis presenting with sequential femoral neck fractures. Operative reduction and fixation was performed. Laboratory result and imaging was consistent with hypophosphataemic osteomalacia. He had bilateral femoral neck non-union and presented with a new left side subtrochanteric femoral fracture. Corrective osteotomy and cephalomedullary fixation was performed. The fractures healed in 6 months after correction of the hypophosphataemia.