Effects of Teriparatide on Clinical and Radiologic Long-Term Outcomes after Fixation of Pertrochanteric Hip Fractures.

Mehdi Hosseini Khameneh, Mona Gorji, Meisam Jafari Kafi-Ababdi, Farsad Biglari, Morteza Gholipour, Keivan Asadi, Amir Sabbaghzadeh
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Abstract

Background: Pertrochanteric hip fractures are common and among serious injuries of the old population with considerable mortality and morbidity. The aim of this study was to evaluate long-term effects of recombinant human parathyroid hormone on postoperative clinical and radiologic outcomes in elderly patients with pertrochanteric hip fractures.

Materials and methods: Between 2016 and 2019, we prospectively assessed 80 patients with pertrochanteric hip fractures who underwent reduction and internal fixation with a dynamic hip screw. Patients were divided randomly into two groups. About 40 patients in the control group who received supplementary calcium (1000 mg/day) and vitamin D (800 UI/day), and 40 others who were treated additionally with 20-28 mg daily teriparatide for three months post-operatively. The functional and radiologic assessment was done using visual analog scale (VAS), Harris hip score (HSS), and standard radiographs of the hip.

Results: At the final follow-up, there was a significant difference between the two groups regarding average HSS (68.38 in the control group versus 74.12 in the treatment group, P-value <0.001). VAS score was also significantly lower in the treatment group (P-value <0.001). Regarding radiographic evidence of union, the results were not statistically different between the two groups.

Conclusions: The current study illustrated that short-term daily administration of teriparatide improves long-term functional outcome after pertrochanteric hip fracture fixation and can reduce the pain but does not affect union and callus formation.

特立帕肽对髋大转子骨折固定后临床和影像学长期预后的影响。
背景:股骨粗隆部骨折是老年人群中常见的严重损伤,具有相当高的死亡率和发病率。本研究的目的是评估重组人甲状旁腺激素对老年股骨粗隆骨折患者术后临床和影像学预后的长期影响。材料和方法:在2016年至2019年期间,我们前瞻性评估了80例髋粗隆骨折患者,这些患者接受了动态髋螺钉复位和内固定。患者随机分为两组。对照组约40例患者接受补钙(1000 mg/天)和维生素D (800 UI/天)治疗,另外40例患者在术后3个月额外治疗特立帕肽20 ~ 28 mg/天。使用视觉模拟量表(VAS)、Harris髋关节评分(HSS)和髋关节标准x线片进行功能和放射学评估。结果:在最后随访时,两组患者的平均HSS有显著差异(对照组68.38,治疗组74.12,p值p值)。结论:目前的研究表明,每日短期服用特立帕肽可改善股骨粗隆骨折固定后的长期功能结局,减轻疼痛,但不影响愈合和骨痂形成。
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