Top

Osteoporosis International

Published in:

01-06-2010 | Case Report

Successful treatment of sternal fracture nonunion with teriparatide

Authors: S. Chintamaneni, K. Finzel, B. L. Gruber

Published in: Osteoporosis International | Issue 6/2010

Abstract

Summary

Fractures have a significant impact on the quality of life for the patient in addition to an enormous indirect cost in lost productivity for our economy. While majority of fractures heal uneventfully, some fail to heal even after many months resulting in nonunion.

Introduction

Sternal nonunions, although rare, are particularly onerous for the patient given the magnitude of impact on quality of life.

Methods

Current treatment for fracture nonunions emphasizes various approaches to surgical fixation in addition to bone grafting. These treatments are aggressive and have a variety of drawbacks, rendering them suboptimal as a therapeutic approach.

Conclusion

Based on the success of teriparatide in animal studies to accelerate fracture healing, there is growing interest in using this drug in humans for the same purpose. We report a case of what we believe to be the first successful use of teriparatide in the healing of a sternal nonunion fracture.

Bishop GB, Einhorn TA (2007) Current and future clinical applications of bone morphogenetic proteins in orthopaedic trauma surgery. Int Orthop 31:721–727CrossRefPubMed

Axelrad TW, Kakar S, Einhorn TA (2007) New technologies for the enhancement of skeletal repair. Injury 38S1:S49–S62

Busse JW, Bhandari M, Sprague S, Johnson-Masotti AP, Gafni A (2005) An economic analysis of management strategies for closed and open grade 1 tibial shaft fractures. Acta Orthop 76:705–712CrossRefPubMed

Wu LC, Renucci JD, Song DH (2005) Sternal nonunion: a review of current treatments and a new method of rigid fixation. Ann Plast Surg 54:55–58CrossRefPubMed

Johnson I, Branfoot T (1992) Sternal fracture-a modern review. Arch Emerg Med 10:24–28CrossRef

Richardson JD, Franklin GA, Heffley S, Seligson D (2007) Operative fixation of chest wall fractures: an underused procedure? Am Surg 73:591–596PubMed

Barnes GL, Kakar S, Vora S, Morgan EF, Gerstenfeld LC, Einhorn TA (2008) Stimulation of fracture-healing with systemic intermittent parathyroid hormone treatment. J Bone Joint Surg Am 90(Suppl1):120–127CrossRefPubMed

Brinker MR, O’Connor DP, Monla YT, Earthman TP (2007) Metabolic and endocrine abnormalities in patients with nonunions. J Orthop Trauma 21:557–570CrossRefPubMed

Mahendra A, Maclean AD (2007) Available biological treatments for complex non-unions. Injury 38S4:S7–S12CrossRef

10.

Finkemeier CG (2002) Bone-grafting and bone-graft substitute. J Bone Joint Surg Am 84-A:454–464PubMed

11.

U.S. Food and Drug Administration. INFUSE® Bone Graft Important Medical Information. Available via http://www.fda.gov/cdrh/PDF4/p000054c.pdf.Accessed 29 March 2009.

12.

U.S. Food and Drug Administration Center For Devices And Radiological Health. New Humanitarian Device Approval OP-1 Putty – H020008. Available via http://www.fda.gov/cdrh/MDA/DOCS/h020008.html. Accessed 29 March 2009.

13.

Skripitz R, Aspenberg P (2004) Parathyroid hormone-a drug for orthopedic surgery? Acta Orthop Scand 75:654–662PubMedCrossRef

14.

Selye H (1932) On the stimulation of new bone formation with parathyroid extract and irradiated ergosterol. Endocrinology 16:547–558CrossRef

15.

Dobnig H, Turner RT (1997) The effects of programmed administration of human parathyroid hormone fragment (1–34) on bone histomorphometry and serum chemistry in rats. Endocrinology 138:4607–4612CrossRefPubMed

16.

Knecht TP (2004) Teriparatide and fracture healing in cortical bone. Endocr Pract 10:293PubMed

17.

Resmini G, Iolascon G (2007) 79-year-old post-menopausal woman with humerus fracture during teriparatide treatment. Aging Clin Exp Res 19(4Suppl):30–31PubMed

18.

Tarantino U, Cannata G, Cerocchi I, Lecce D, Iundusi R, Celi M (2007) Surgical approach to fragility fractures: problems and perspectives. Aging Clin Exp Res 19(4Suppl):12–21PubMed

Title: Successful treatment of sternal fracture nonunion with teriparatide
Authors: S. Chintamaneni
K. Finzel
B. L. Gruber
Publication date: 01-06-2010
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 6/2010
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-009-1061-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Successful treatment of sternal fracture nonunion with teriparatide

Abstract

Summary

Introduction

Methods

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2010

Bone loss in relation to serum levels of osteoprotegerin and nuclear factor-κB ligand: the Tromsø Study

Erratum to: Morphological changes of injected calcium phosphate cement in osteoporotic compressed vertebral bodies

Selecting men for bone densitometry: performance of osteoporosis risk assessment tools in Portuguese men

Higher sea fish intake is associated with greater bone mass and lower osteoporosis risk in postmenopausal Chinese women

Longitudinal change in clinical fracture incidence after initiation of bisphosphonates

Compromised bone strength index in the hemiparetic distal tibia epiphysis among chronic stroke patients: the association with cardiovascular function, muscle atrophy, mobility, and spasticity