The biology of bone repair and healing is interesting and a huge number of studies have been done in this aspect with the potential technologies for enhancing fracture-healing. Teriparatide an anabolic agent a recombinant parathyroid hormone preparation that activates osteoblastic bone formation has been used in the treatment of postmenopausal osteoporosis. It has also been reported to be effective in accelerating the rate of fracture healing. The conclusion that PTH as an effective anabolic therapy for the enhancement of bone repair after fracture has been studied in animals and very few case studies. This prospective study was conducted to determine and establish the role of recombinant teriparatide in fracture healing in delayed union fractures, osteoporotic fractures, periprosthetic fractures.
Materials and Methods: The study was done on 20 patients with fractures selected on the basis of inclusion and exclusion criteria at Shashwat hospital, Pune during the period of September 2011 to September 2015. All patients were administered 20ug of teriparatide injections daily. The injections were given for 2 - 4 months depending on type of fracture and the time required for radiological evidence of union. Radiographs were taken every 4 weeks to see for callus and fracture union. The primary endpoint of fracture healing was taken as the time of cortical bridging in three of four cortices Results: The fractures treated with 20ug of teriparatide exhibited early signs of union with abundant callus formation significant decrease in radiological union time and early rehabilitation of patients in all three groups.
Conclusions: This study shows that the daily systemic administration of recombinant teriparatide enhances fracture-healing by increasing bone mineral content, density and strength. It also produces a sustained anabolic effect throughout the remodeling phase of fracture-healing. It also emphasizes that teriparatide is a relatively safe drug. Economical compared to other options of fracture healing like bone grafting, second surgery and is less invasive and has better patient compliance.