Does short-term weekly teriparatide improve healing in unstable intertrochanteric fractures?

Slow recovery after hip fracture has been associated with negative consequences. Thus, there is medical need to improve healing and functional recovery after intertrochanteric fracture. The aim of this study was to measure whether short-term teriparatide would improve healing in intertrochanteric fr...

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Main Authors: Seung-Ju Kim, Hyun-Soo Park, Dong-Woo Lee, Jae-Won Lee
Format: Article
Language:English
Published: SAGE Publishing 2018-10-01
Series:Journal of Orthopaedic Surgery
Online Access:https://doi.org/10.1177/2309499018802485
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author Seung-Ju Kim
Hyun-Soo Park
Dong-Woo Lee
Jae-Won Lee
author_facet Seung-Ju Kim
Hyun-Soo Park
Dong-Woo Lee
Jae-Won Lee
author_sort Seung-Ju Kim
collection DOAJ
description Slow recovery after hip fracture has been associated with negative consequences. Thus, there is medical need to improve healing and functional recovery after intertrochanteric fracture. The aim of this study was to measure whether short-term teriparatide would improve healing in intertrochanteric fractures after internal fixation as measured by (1) clinical scores, (2) radiographic fracture healing, and (3) complication rates. We retrospectively reviewed 96 patients (average age, 82 years) who underwent closed reduction and internal fixation with proximal femoral nail (PFN) for unstable intertrochanteric fractures between 2014 and 2016. Of the 96 patients, 56 patients were treated with a PFN alone (group 1). These patients were compared with 46 patients for whom the same device was used and a weekly subcutaneous injection of PTH 1-34 (teriparatide) was prescribed postoperatively (group 2). Questionnaire surveys or telephone interviews were conducted, and patients completed a self-report Harris hip score and visual analog scale scores. The radiological time to fracture healing was assessed as the primary end point. Postoperative complication rates were compared. Functional outcomes at 6 months after surgery were similar in both groups. There were no differences between groups in the proportion of patients achieving radiographic fracture healing. The frequency of patients reporting adverse events was 20% (10 of 50) in group 1 versus 17% (8 of 46) in group 2 ( p = 0.744). Short-term teriparatide did not improve radiographic signs of fracture healing of an intertrochanteric fracture and reduce the incidence of complications. The effect of teriparatide on fracture healing remains uncertain. Further multicenter prospective studies are needed to demonstrate objective long-term results of parathyroid hormone therapy in patient with hip fracture. Level of Evidence: Level IV, therapeutic study.
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spelling doaj.art-6376ae69e84f4da3b7a2901627d2a3822022-12-21T18:38:09ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902018-10-012610.1177/2309499018802485Does short-term weekly teriparatide improve healing in unstable intertrochanteric fractures?Seung-Ju KimHyun-Soo ParkDong-Woo LeeJae-Won LeeSlow recovery after hip fracture has been associated with negative consequences. Thus, there is medical need to improve healing and functional recovery after intertrochanteric fracture. The aim of this study was to measure whether short-term teriparatide would improve healing in intertrochanteric fractures after internal fixation as measured by (1) clinical scores, (2) radiographic fracture healing, and (3) complication rates. We retrospectively reviewed 96 patients (average age, 82 years) who underwent closed reduction and internal fixation with proximal femoral nail (PFN) for unstable intertrochanteric fractures between 2014 and 2016. Of the 96 patients, 56 patients were treated with a PFN alone (group 1). These patients were compared with 46 patients for whom the same device was used and a weekly subcutaneous injection of PTH 1-34 (teriparatide) was prescribed postoperatively (group 2). Questionnaire surveys or telephone interviews were conducted, and patients completed a self-report Harris hip score and visual analog scale scores. The radiological time to fracture healing was assessed as the primary end point. Postoperative complication rates were compared. Functional outcomes at 6 months after surgery were similar in both groups. There were no differences between groups in the proportion of patients achieving radiographic fracture healing. The frequency of patients reporting adverse events was 20% (10 of 50) in group 1 versus 17% (8 of 46) in group 2 ( p = 0.744). Short-term teriparatide did not improve radiographic signs of fracture healing of an intertrochanteric fracture and reduce the incidence of complications. The effect of teriparatide on fracture healing remains uncertain. Further multicenter prospective studies are needed to demonstrate objective long-term results of parathyroid hormone therapy in patient with hip fracture. Level of Evidence: Level IV, therapeutic study.https://doi.org/10.1177/2309499018802485
spellingShingle Seung-Ju Kim
Hyun-Soo Park
Dong-Woo Lee
Jae-Won Lee
Does short-term weekly teriparatide improve healing in unstable intertrochanteric fractures?
Journal of Orthopaedic Surgery
title Does short-term weekly teriparatide improve healing in unstable intertrochanteric fractures?
title_full Does short-term weekly teriparatide improve healing in unstable intertrochanteric fractures?
title_fullStr Does short-term weekly teriparatide improve healing in unstable intertrochanteric fractures?
title_full_unstemmed Does short-term weekly teriparatide improve healing in unstable intertrochanteric fractures?
title_short Does short-term weekly teriparatide improve healing in unstable intertrochanteric fractures?
title_sort does short term weekly teriparatide improve healing in unstable intertrochanteric fractures
url https://doi.org/10.1177/2309499018802485
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