ABSTRACT
Metabolic bone disorders are associated with critical alterations in the regulation of bone formation, bone resorption and distribution of minerals in bone. Clinical features arise from both systemic responses to changes in mineral exchange and local effects of abnormal bone structure and composition. Orthopaedic surgeons deal mainly with the bone abnormalities (e.g. rickety deformities in growing bones or insufficiency fractures in the elderly) but it is important also to be aware of the systemic disorders that may lie behind apparently straightforward ‘orthopaedic’ defects and to understand the unseen metabolic changes that influence the outcome of many of our surgical interventions.
