Effect of Teriparatide in Fracture Healing in Elderly.

Abstract

Introduction: Teriparatide (TPTD), a recombinant form of the biologically active Parathyroid hormone, has been shown to increase bone mass and prevent fractures by increasing serum calcium levels in response to systemic hypocalcemia. Studies have shown improvements in callus volume and mineralization, bone mineral content, rate of successful union, and strength at fracture sites, and produce a sustained anabolic effect throughout the remodeling phase of fracture healing. The present study was done to evaluate the efficacy of TPTD in hastening fracture healing in elderly patients by clinical, radiological, and biochemical parameters.

Materials and methods: A prospective case-control study was done on elderly patients (>55 years) with fractures. Pre-operative bone mineral profile assessed. All fractures were surgically fixed. All patients postoperatively on day 5 were started on injection TPTD 20 mcg daily for 8 weeks. Immediate post-operative radiographs and at 4 weeks, 8 weeks (after completion of TPTD), and 16 weeks were taken to assess the radiological Callus Index score. After completion of 8 weeks, a bone mineral profile was done to assess any biochemical changes in response to TPTD usage. Functional assessment was done with a Visual Analog Scale score and a two-minute walk test. All the results were compared with the non-TPTD group.

Results: The use of TPTD showed improvement in bone mineral content and better functional and radiological outcomes compared to the control group.

Conclusion: Both TPTD and Non-TPTD group patients showed fracture healing, but the duration of healing was significantly shorter in the TPTD group. Functional assessment showed better pain control and an increase in the two-minute walk test distances in the TPTD group.