Guo SH, Li C, Gao YJ, Zhang Z, Lu K. Teriparatide as a non-surgical salvage therapy for prolonged humerus fracture nonunion: A case report and literature review. World J Orthop 2025; 16(1): 101656 [PMID: 39850036 DOI: 10.5312/wjo.v16.i1.101656]
Corresponding Author of This Article
Ke Lu, MD, Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou 215300, Jiangsu Province, China. sgu8434@sina.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Jan 18, 2025; 16(1): 101656 Published online Jan 18, 2025. doi: 10.5312/wjo.v16.i1.101656
Teriparatide as a non-surgical salvage therapy for prolonged humerus fracture nonunion: A case report and literature review
Shao-Han Guo, Chong Li, Yi-Jun Gao, Zhen Zhang, Ke Lu
Shao-Han Guo, Chong Li, Yi-Jun Gao, Ke Lu, Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou 215300, Jiangsu Province, China
Zhen Zhang, Department of Radiology, Affiliated Kunshan Hospital of Jiangsu University, Suzhou 215300, Jiangsu Province, China
Author contributions: Guo SH drafted the manuscript; Guo SH and Zhang Z contributed to the acquisition of data; Li C and Lu K approved the final manuscript; Gao YJ and Lu K revised the manuscript; Lu K contributed to the study conception and design; Guo SH, Li C, Gao YJ, Zhang Z, Lu K were all involved in the diagnosis, management, and care of the patient; all of the authors read and approved the final version of the manuscript to be published.
Supported by National Natural Science Foundation of China, No. 82172441; Suzhou City Major Disease Multicenter Clinical Research Project, No. DZXYJ202312; Special Funding for Jiangsu Province Science and Technology Plan (Key Research and Development Program for Social Development), No. BE2023737; Gusu Health Talent Plan Scientific Research Project, No. GSWS2022109; and Postgraduate Research and Practice Innovation Program of Jiangsu Province, No. SJCX24_2446.
Informed consent statement: Informed consent was obtained from all individual patients included in the study.
Conflict-of-interest statement: All authors state they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ke Lu, MD, Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou 215300, Jiangsu Province, China. sgu8434@sina.com
Received: September 22, 2024 Revised: December 12, 2024 Accepted: January 2, 2025 Published online: January 18, 2025 Processing time: 112 Days and 19.9 Hours
Abstract
BACKGROUND
Fracture nonunion represents a challenging complication during fracture repair, often necessitating surgical intervention. Teriparatide, a recombinant human parathyroid hormone, has demonstrated promise in enhancing fracture healing, although its efficacy in treating established nonunion remains under investigation.
CASE SUMMARY
We report a case of a 27-year-old male who presented with a right humerus fracture following a traffic accident. Despite undergoing open reduction and internal fixation, the fracture resulted in a delayed union and subsequent nonunion. After 4 years of conservative management, teriparatide treatment was initiated due to persistent nonunion. Teriparatide injections were administered daily for 6 months, resulting in complete fracture healing and resolution of pain.
CONCLUSION
Our case demonstrates the successful use of teriparatide in treating a prolonged nonunion of a humerus fracture. Teriparatide may provide a valuable therapeutic option for established bone nonunion, even in cases that have not responded to conservative treatments.
Core Tip: This case report highlights the successful use of teriparatide, a recombinant form of parathyroid hormone, in a patient with a four-year history of nonunion following a humeral fracture. This is the first documented case of teriparatide being used to treat nonunion of such prolonged duration. The report underscores the role of teriparatide in bone regeneration and repair, demonstrating its potential as a valuable non-surgical treatment option when conventional therapies have failed.
