Effect of daily teriparatide for delayed union of fracture neck of the femur

Abstract

Background: Delayed union and nonunion of fracture neck of the femur remains a therapeutic challenge to orthopedic surgeons worldwide which is why this fracture is aptly named as unsolved fracture. Hip joint preservation surgery always remains the primary criteria in fracture neck of the femur in physiologically young patients. However, the outcome is not always satisfactory due to many factors, delayed presentation being one of them. This case series was conducted to determine and establish the role of recombinant teriparatide in fracture healing in delayed union of fracture neck of the femur. Materials and Methods: The study was done on nine cases (six males and three females) of delayed union of fracture neck of the femur with a previous history of some surgical interventions. All cases of delayed union were diagnosed by clinically and radiologically and undergone all routine blood investigations. All were administered 20 μg of teriparatide (recombinant parathormone) subcutaneous injection daily for a period of 3–5 months. Results: Eight patients who were evaluated clinically and radiologically showed satisfactory union and one case showed nonunion. One patient showed mild allergic reaction. Conclusion: This study showed that daily administration of teriparatide accelerates fracture healing in delayed union. It also enhances fracture healing throughout the period of bone remodeling phase. It also emphasizes the safety of teriparatide.