To explore the early diagnosis and improve the treatment of primary hyperparathyroidism.

Five patients of pathological fracture caused by primary hyperparathyroidism (PHPT), who admitted to Shandong Provincial Hospital in recent 3 years were enrolled in this study.

Distensible bone destruction was found by imageological examination in 5 patients, the other 2 cases were bone cyst and aneurysmal bone cyst respectively.Four patients with preoperative test indicators of typical hypercalcemia, hypophosphatemia, and the levels of alkaline phosphatase and PTH were significantly increased.The diagnosis of PHPT was further diagnosed by neck ultrasonography and parathyroid ^99mTc-MIBI examination.Parathyroid gland surgery was performed in 3 cases, postoperative pathology was parathyroid adenoma, and 2 cases were transferred to the department of endocrinology for symptomatic treatment.Five patients were followed up for 6 to 24 months, and sclerotin of all patients had been repaired with different degree, callus growth was continuous.

The simultaneous increase of serum calcium and PTH is an important basis for the diagnosis of PHPT.Early detection of serum calcium, phosphorus and PTH, parathyroid ultrasonography and ^99mTc-MIBI can diagnose PHPT early and can improve the cure rate.