The Role of Teriparatide in the Management of Fracture Non-Union: A Systematic Review of Case Reports

Ervin Chino N. Tayag, Charles Abraham C. Villamin

May 2020 DOI 10.35460/2546-1621.2019-0006     Access   

Abstract

Teriparatide has been known to aid in the treatment of osteoporosis but its use in the management of fracture disorders is poorly documented. This review aims to show that teriparatide administration may improve the healing process in fractures that fail to unite after sustaining trauma. A total of 22 reported cases have been identified from 2009 to 2017. Teriparatide doses were given in a median duration of 5.6 months with a median time to complete union of 8.5 months. This review systematically summarizes all clinical case reports of non-union treated with teriparatide for us to gain insight into its off-label use.

  1. Bhalla AK. Use of teriparatide (TP) in fracture healing. Bone. 2010(47):S27.
  2. Ciurlia E, Leali PT, Doria C. Use of teriparatide off-label: our experience and review of literature. Clinical Cases in Mineral and Bone Metabolism. 2017 Jan;14(1):28.
  3. Chintamaneni S, Finzel K, Gruber BL. Successful treatment of sternal fracture nonunion with teriparatide. Osteoporosis International. 2010 Jun 1;21(6):1059–63.
  4. Emanuele C, Leonardo P, Gianfilippo C, Matteo A, Doria C. Peri-prosthetic humeral non-union: Where biology meets bio-mechanic. A case report. International Journal of Surgery Case Reports. 2017 Jan 1;39:102–5.
  5. Garg B, Batra S, Dixit V. An unexpected healing of an established non-union of the radial neck through teriparatide: A case report and review of literature. Journal of Clinical Orthopaedics and Trauma. 2018 Mar;9(Suppl 1):S103.
  6. Lee YK, Ha YC, Koo KH. Teriparatide, a nonsurgical solution for femoral nonunion? A report of three cases. Osteoporosis International. 2012 Dec 1;23(12):2897–900.
  7. Mitani Y. Effective treatment of a steroid-induced femoral neck fracture nonunion with a once-weekly administration of teriparatide in a rheumatoid patient: a case report. Archives of Osteoporosis. 2013 Dec 1;8(1–2):131.
  8. Nozaka K, Shimada Y, Miyakoshi N, Yamada S, Hongo M, Kasukawa Y, et al. Combined effect of teriparatide and low-intensity pulsed ultrasound for nonunion: a case report. BMC Research Notes. 2014 Dec;7(1):317.
  9. Ochi K, Ikari K, Naomi A, Momohara S. Administration of teriparatide treatment for a challenging case of nonunion of periprosthetic fracture after total knee arthroplasty. Archives of Osteoporosis. 2013 Dec 1;8(1–2):159.
  10. Oteo-Álvaro Á, Marín MT. Nonunion of the humeral shaft successfully treated with teriparatide [rh (1-34) PTH]. Case Reports in Clinical Medicine. 2013 Mar 7;2(1):11–5.
  11. Oteo-Álvaro Á, Moreno E. Atrophic humeral shaft nonunion treated with teriparatide (rh PTH 1-34): a case report. Journal of Shoulder and Elbow Surgery. 2010 Oct 1;19(7):e22–8.
  12. Pietrogrande L, Raimondo E. Teriparatide in the treatment of non-unions: scientific and clinical evidences. Injury. 2013 Jan 1;44:S54–7.
  13. Pola E, Pambianco V, Colangelo D, Formica VM, Autore G, Nasto LA. Teriparatide anabolic therapy as potential treatment of type II dens non-union fractures. World Journal of Orthopedics. 2017 Jan 18;8(1):82.
  14. Tamai K, Takamatsu K, Kazuki K. Successful treatment of nonunion with teriparatide after failed ankle arthrodesis for Charcot arthropathy. Osteoporosis International. 2013 Oct 1;24(10):2729–32.
  15. Uemura T, Okada M, Yokoi T, Shintani K, Nakamura H. Successful bone healing of nonunion after ulnar shortening osteotomy for smokers treated with teriparatide. Orthopedics. 2015 Aug 20;38(8):e733–7.
  16. Xiaofeng L, Daxia X, Yunzhen C. Teriparatide as a nonoperative treatment for tibial and femoral fracture nonunion: A case report. Medicine. 2017 Apr;96(16):e6571.
  17. Yu W, Guo X. Teriparatide treatment of femoral fracture nonunion that autogenous bone grafting failed to heal: a case report. Archives of Osteoporosis. 2017 Dec 1;12(1):15.
  18. Coppola C, Del Buono A, Maffulli N. Teriparatide in fracture non-unions. Translational Medicine@ UniSa. 2015 May;12:47.

     

Articles related to the one you are viewing

There are currently no results to show, please try again later

CC BY: Open Access Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/