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Teriparatide in Fracture Non-Unions.

Coppola C, Del Buono A, Maffulli N - Transl Med UniSa (2014)

Bottom Line: Teriparatide administration resulted in adequate bone callus over the site of nonunion in all the patients, and clinical and radiographic evidence of sound union.It may induce an angiogenetic response which counteracts the features responsible for development of non-union.Level IV, therapeutic case series.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic and Trauma Surgery, Hospital "S. Maria di Loreto Nuovo", Naples, Italy.

ABSTRACT

Background: The use of teriparatide in the management of fracture disorders is poorly documented. This study aims to show that teriparatide administration may improve the healing process in patients with nonunions after open fixation of traumatic fractures of the lower limb.

Methods: Four patients received Teriparatide for management of non-unions after open fixation of traumatic fractures of the lower limb.

Results: Teriparatide administration resulted in adequate bone callus over the site of nonunion in all the patients, and clinical and radiographic evidence of sound union.

Conclusions: The efficacy of teriparatide in delayed or non unions is still unclear. It may induce an angiogenetic response which counteracts the features responsible for development of non-union.

Level of evidence: Level IV, therapeutic case series.

No MeSH data available.


Related in: MedlinePlus

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Mentions: A 30-year-old healthy, engineer, nonsmoking male underwent reduction and external fixation (Hoffmann II device) of 43A.3 (by AO classification) Gustilo III 3B fracture of the left tibia and fibula. At 4 months, radiographs did not show any signs of bone healing (Fig 9). At that time, the patient underwent removal of the external fixator and administration of teriparatide (20 μg subcutaneous injection daily), calcium and vitamin D. Given the soft tissue impairment, he could only undergo hyperbaric therapy and plastic surgical procedures. After 4 months of therapy, radiographs showed good integration of the bone, and adequate bone callus over the site of nonunion (Fig 10). Eight months later, he could work and swim. Ankle extension was 10°, flexion 20°.


Teriparatide in Fracture Non-Unions.

Coppola C, Del Buono A, Maffulli N - Transl Med UniSa (2014)

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4592043&req=5

Mentions: A 30-year-old healthy, engineer, nonsmoking male underwent reduction and external fixation (Hoffmann II device) of 43A.3 (by AO classification) Gustilo III 3B fracture of the left tibia and fibula. At 4 months, radiographs did not show any signs of bone healing (Fig 9). At that time, the patient underwent removal of the external fixator and administration of teriparatide (20 μg subcutaneous injection daily), calcium and vitamin D. Given the soft tissue impairment, he could only undergo hyperbaric therapy and plastic surgical procedures. After 4 months of therapy, radiographs showed good integration of the bone, and adequate bone callus over the site of nonunion (Fig 10). Eight months later, he could work and swim. Ankle extension was 10°, flexion 20°.

Bottom Line: Teriparatide administration resulted in adequate bone callus over the site of nonunion in all the patients, and clinical and radiographic evidence of sound union.It may induce an angiogenetic response which counteracts the features responsible for development of non-union.Level IV, therapeutic case series.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic and Trauma Surgery, Hospital "S. Maria di Loreto Nuovo", Naples, Italy.

ABSTRACT

Background: The use of teriparatide in the management of fracture disorders is poorly documented. This study aims to show that teriparatide administration may improve the healing process in patients with nonunions after open fixation of traumatic fractures of the lower limb.

Methods: Four patients received Teriparatide for management of non-unions after open fixation of traumatic fractures of the lower limb.

Results: Teriparatide administration resulted in adequate bone callus over the site of nonunion in all the patients, and clinical and radiographic evidence of sound union.

Conclusions: The efficacy of teriparatide in delayed or non unions is still unclear. It may induce an angiogenetic response which counteracts the features responsible for development of non-union.

Level of evidence: Level IV, therapeutic case series.

No MeSH data available.


Related in: MedlinePlus