Teriparatide (20 μg daily) accelerates long bone fracture union in 81.2% of patients with delayed healing

Delayed union of long bone fractures poses a significant clinical challenge, leading to prolonged morbidity and functional limitations. Current management often involves surgical reintervention, which carries its own risks. Teriparatide, a recombinant human parathyroid hormone (PTH 1-34), is known for its anabolic effects on bone, stimulating osteoblast activity and bone formation. This study explores its potential as a biological enhancer to bridge the treatment gap for patients experiencing delayed fracture healing, aiming to reduce the need for invasive procedures.

A prospective interventional study enrolled 48 adult patients (mean age: 42.6 ± 11.2 years) with delayed union of long bone fractures (tibia, femur, humerus, radius/ulna) between 3 and 9 months post-injury. All patients received teriparatide 20 μg daily SC for 3 months, alongside calcium and vitamin D supplementation. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for pain and weight-bearing ability. Radiological healing was evaluated via the Radiographic Union Score for Tibial fractures (RUST) and cortical bridging on serial radiographs at 0, 6, and 12 weeks.

Daily teriparatide significantly improved both clinical and radiological outcomes. The mean VAS score for pain dramatically reduced from 7.8 ± 1.1 at baseline to 2.1 ± 0.9 at 12 weeks (P < 0.001). Clinical union was achieved in 87.5% of patients, with 91.7% regaining full weight-bearing ability. Radiological assessments showed substantial progress: the mean RUST score improved from 5.2 ± 1.3 to 10.3 ± 1.2 (P < 0.001). Metaphyseal fractures and those with stable fixation demonstrated superior outcomes.

Radiological union was observed in 81.2% of patients at 12 weeks following teriparatide treatment. No major adverse events were reported, indicating a favorable safety profile for this intervention.