Tsai MH, Hu CC. Teriparatide as nonoperative treatment for femoral shaft atrophic nonunion: A case report. World J Clin Cases 2019; 7(18): 2838-2842 [PMID: 31616700 DOI: 10.12998/wjcc.v7.i18.2838]
Corresponding Author of This Article
Chih-Chien Hu, MD, Assistant Professor, Department of Joint Reconstruction, Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital, Lin-Kou Medical Center, No. 5, Fu-Hsin St. Kwei-Shan District, Taoyuan 33305, Taiwan. chihchienhu@hotmail.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 Clin Cases. Sep 26, 2019; 7(18): 2838-2842 Published online Sep 26, 2019. doi: 10.12998/wjcc.v7.i18.2838
Teriparatide as nonoperative treatment for femoral shaft atrophic nonunion: A case report
Meng-Huan Tsai, Chih-Chien Hu
Meng-Huan Tsai, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
Meng-Huan Tsai, Chih-Chien Hu, Department of Joint Reconstruction, Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taoyuan 33305, Taiwan
Author contributions: Tsai MH reviewed the literature and contributed to manuscript drafting; Hu CC was the patient’s orthopedic doctor, reviewed the literature and contributed to manuscript drafting.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2013), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: 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/
Corresponding author: Chih-Chien Hu, MD, Assistant Professor, Department of Joint Reconstruction, Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital, Lin-Kou Medical Center, No. 5, Fu-Hsin St. Kwei-Shan District, Taoyuan 33305, Taiwan. chihchienhu@hotmail.com
Telephone: +886-3-3281200
Received: February 27, 2019 Peer-review started: February 27, 2019 First decision: July 30, 2019 Revised: August 8, 2019 Accepted: August 25, 2019 Article in press: August 26, 2019 Published online: September 26, 2019 Processing time: 209 Days and 17.1 Hours
Abstract
BACKGROUND
Femoral shaft fractures are a common type of fracture among adults and have high union rates. However, clinical decisions are difficult to make because of the different types of nonunions. Atrophic nonunion usually requires revision surgery combined with bone grafting. Furthermore, no study of teriparatide administration for femoral atrophic nonunion have been previously reported.
CASE SUMMARY
A 60-year-old woman had a right femoral shaft fracture due to a traffic accident, and she immediately underwent closed reduction and internal fixation surgery with an intramedullary nailing. However, after 6 mo of rehabilitation, the fracture site showed no signs of healing, and her condition was diagnosed as atrophic nonunion. Subsequently, teriparatide was administered for 6 mo. Complete union was observed at the fracture site 6 mo after teriparatide discontinued.
CONCLUSION
The use of teriparatide can be a promising treatment to improve the healing of nonunion fractures.
Core tip: This is the first report describing the treatment of femoral shaft atrophic nonunion after an operative reduction and internal fixation procedure using only teriparatide administration instead of revision surgery. Our data provides an alternative treatment option for patients with atrophic nonunion.
