Top

Published in:

01-12-2012 | Case Report

Teriparatide, a nonsurgical solution for femoral nonunion? A report of three cases

Authors: Y.-K. Lee, Y.-C. Ha, K.-H. Koo

Published in: Osteoporosis International | Issue 12/2012

Abstract

We medicated teriparatide in three patients, who had a nonunion of the femur even after the initial surgical intervention. Teriparatide was administered for 3–9 months after a diagnosis of nonunion. A successful union was obtained in all three patients without further surgical intervention, and no adverse events related to the use of teriparatide were observed. Our report showed that teriparatide could be an alternative to surgical intervention in nonunion of the femur.

Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, Hodsman AB, Eriksen EF, Ish-Shalom S, Genant HK, Wang O, Mitlak BH (2001) Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 344:1434–1441PubMedCrossRef

Jiang Y, Zhao JJ, Mitlak BH, Wang O, Genant HK, Eriksen EF (2003) Recombinant human parathyroid hormone (1-34) [teriparatide] improves both cortical and cancellous bone structure. J Bone Miner Res 18:1932–1941PubMedCrossRef

Zanchetta JR, Bogado CE, Ferretti JL, Wang O, Wilson MG, Sato M, Gaich GA, Dalsky GP, Myers SL (2003) Effects of teriparatide [recombinant human parathyroid hormone (1-34)] on cortical bone in postmenopausal women with osteoporosis. J Bone Miner Res 18:539–543PubMedCrossRef

Rubin MR, Cosman F, Lindsay R, Bilezikian JP (2002) The anabolic effects of parathyroid hormone. Osteoporos Int 13:267–277PubMedCrossRef

Cipriano CA, Issack PS, Shindle L, Werner CM, Helfet DL, Lane JM (2009) Recent advances toward the clinical application of PTH (1-34) in fracture healing. HSS J 5:149–153PubMedCrossRef

Daugaard H, Elmengaard B, Andreassen TT, Baas J, Bechtold JE, Soballe K (2011) The combined effect of parathyroid hormone and bone graft on implant fixation. J Bone Joint Surg Br 93:131–139PubMedCrossRef

O’Loughlin PF, Cunningham ME, Bukata SV, Tomin E, Poynton AR, Doty SB, Sama AA, Lane JM (2009) Parathyroid hormone (1-34) augments spinal fusion, fusion mass volume, and fusion mass quality in a rabbit spinal fusion model. Spine (Phila Pa 1976) 34:121–130CrossRef

Jacobson JA, Yanoso-Scholl L, Reynolds DG, Dadali T, Bradica G, Bukata S, Puzas EJ, Zuscik MJ, Rosier R, O’Keefe RJ, Schwarz EM, Awad HA (2011) Teriparatide therapy and beta-tricalcium phosphate enhance scaffold reconstruction of mouse femoral defects. Tissue Eng Part A 17:389–398PubMedCrossRef

Aspenberg P, Genant HK, Johansson T, Nino AJ, See K, Krohn K, Garcia-Hernandez PA, Recknor CP, Einhorn TA, Dalsky GP, Mitlak BH, Fierlinger A, Lakshmanan MC (2010) Teriparatide for acceleration of fracture repair in humans: a prospective, randomized, double-blind study of 102 postmenopausal women with distal radial fractures. J Bone Miner Res 25:404–414PubMedCrossRef

10.

Peichl P, Holzer LA, Maier R, Holzer G (2011) Parathyroid hormone 1-84 accelerates fracture-healing in pubic bones of elderly osteoporotic women. J Bone Joint Surg Am 93:1583–1587PubMedCrossRef

11.

Puzas JE, Houck J, Bukata SV (2006) Accelerated fracture healing. J Am Acad Orthop Surg 14:S145–151PubMed

12.

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

13.

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

14.

Marsh D (1998) Concepts of fracture union, delayed union, and nonunion. Clin Orthop Relat Res S22-30

15.

Pihlajamaki HK, Salminen ST, Bostman OM (2002) The treatment of nonunions following intramedullary nailing of femoral shaft fractures. J Orthop Trauma 16:394–402PubMedCrossRef

16.

Rodriguez-Merchan EC, Gomez-Castresana F (2004) Internal fixation of nonunions. Clin Orthop Relat Res 13-20

17.

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(Suppl 1):120–127PubMedCrossRef

18.

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

19.

Mahendra A, Maclean AD (2007) Available biological treatments for complex non-unions. Injury 38(Suppl 4):S7–12PubMedCrossRef

20.

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

21.

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

22.

Oteo-Alvaro A, Moreno E (2010) Atrophic humeral shaft nonunion treated with teriparatide (rh PTH 1-34): a case report. J Shoulder Elbow Surg 19:e22–28PubMedCrossRef

23.

Rubery PT, Bukata SV (2010) Teriparatide may accelerate healing in delayed unions of type III odontoid fractures: a report of 3 cases. J Spinal Disord Tech 23:151–155PubMedCrossRef

24.

Chintamaneni S, Finzel K, Gruber BL (2010) Successful treatment of sternal fracture nonunion with teriparatide. Osteoporos Int 21:1059–1063PubMedCrossRef

Title: Teriparatide, a nonsurgical solution for femoral nonunion? A report of three cases
Authors: Y.-K. Lee
Y.-C. Ha
K.-H. Koo
Publication date: 01-12-2012
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 12/2012
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-012-2172-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Teriparatide, a nonsurgical solution for femoral nonunion? A report of three cases

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 12/2012

Age-related changes in proximal humerus bone health in healthy, white males

Predictive factors of change in BMD at 1 and 2 years in women with anorexia nervosa: a study of 146 cases

Delay from fracture to hospital admission: a new risk factor for hip fracture mortality?

Bone mineral density by DXA and HR pQCT can discriminate fracture status in men and women with stages 3 to 5 chronic kidney disease

Effects of morning vs. evening teriparatide injection on bone mineral density and bone turnover markers in postmenopausal osteoporosis

Health-related quality of life in patients with osteoporosis in the absence of vertebral fracture: a systematic review