DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20180687

Successful treatment of nonuniting fracture ICNF with Teriparatide in young adult osteopenic male

Sujoy Kundu

Abstract


We present a case of fracture intra capsular neck of femur in a young adult osteopenic patient, who had a nonunion and early signs of avascular necrosis even after the initial surgical intervention. Teriparatide was administered for two monthly doses after diagnosis of nonunion and avascular necrosis of femoral neck. 90% successful union was achieved in 2 months without further surgical intervention, and no adverse events related to the use of teriparatide were observed. Our case report shows that teriparatide can be an alternative to surgical intervention in nonunion of ICNF with early signs of avascular necrosis.


Keywords


Teriparatide, Nonunion, Avascular necrosis, Intracapsular fracture neck femur, Accelerated fracture healing, Osteopenic

Full Text:

PDF

References


Robinson CM, Court-Brown CM, McQueen MM, Christie J. Hip fractures in adults younger than 50 years of age. Epidemiology and results. Clin Orthop Relat Res. 1995;(312):238-46.

Ravikumar K.J., Marsh G. Internal fixation versus hemiarthroplasty versus total hip replacement for displaced sub capital fractures of femur. 13 year results of prospective randomised study. Injury. 2003;31:793–7.

Mathews V, Cabanela ME. Femoral neck nonunion treatment. Clin Orthop Relat Res. 2004;419:57-64.

Borggrefe J, Graeff C, Nickelsen TN, Marin F, Glüer CC. Quantitative computed tomographic assessment of the effects of 24 months of teriparatide treatment on 3D femoral neck bone distribution, geometry, and bone strength: results from the EUROFORS study. J Bone Miner Res. 2010;25(3):472-81.

Sibai T, Morgan EF, Einhorn TA. Anabolic agents and bone quality. Clin Orthop Relat Res. 2011;469(8):2215-24.

Lee YK, Ha YC, Koo KH. Teriparatide, a nonsurgical solution for femoral nonunion? A report of three cases. Osteoporos Int. 2012;23(12):2897-900.

Coppola C, Del Buono A, Maffulli N. Teriparatide in Fracture Non-Unions. Translational Medicine @ UniSa. 2015;12:47-53.

Chintamaneni S, Finzel K, Gruber BL. Successful treatment of sternal fracture nonunion with teriparatide. Osteoporos Int. 2010;21(6):1059-63.

Oteo-Alvaro A, Moreno E. Atrophic humeral shaft nonunion treated with teriparatide (rh PTH 1-34): a case report. J Shoulder Elbow Surg. 2010;19(7):e22-8.

Resmini G, Iolascon G. 79-year-old post-menopausal woman with humerus fracture during teriparatide treatment. Aging Clin Exp Res. 2007;19(4):30-1.