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Teriparatide therapy: case reports suggest it can accelerate fracture healing



DOI:10.1038/bonekey.2013.89

Giannotti et al. present a case report of an 80-year-old woman who sustained a distal metaphyseal femoral fracture just above the knee on the right side, complicated by a pre-existing complete knee arthroplasty. After surgical intervention with an open reduction rigid fixation plus a lateral locking plate, she was followed for 7 months. No evidence of healing was apparent by radiography. The patient then received teriparatide treatment for 8 weeks, at which point bone bridges became visible on X-ray. After a further 3 months of teriparatide treatment, her fracture had healed completely.

Lee et al. describe three patients with nonunion femoral fractures treated with teriparatide for 3–9 months after their nonunion was diagnosed. The first was a man aged 38 years with a closed left femoral shaft fracture, the second was a woman aged 64 years with a distal femoral fracture, also due to trauma, and the third was a 29-year-old man with a right femoral neck fracture. All patients sustained their fractures through accidental trauma and all three achieved healing of their fracture with full union after teriparatide therapy, without the need for surgery.

Editor’s comment: These two publications describe four cases of non-union fracture successfully treated with teriparatide in an uncontrolled manner. Controlled clinical trial evidence is needed urgently.


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