Use of teriparatide in preventing delayed bone healing in complex biosseous leg fracture: a case report

Abstract

Fracture nonunion is one of the greatest challenges for orthopedic surgeons. We present the case of a young man with a complex open biosseous fracture of the leg who underwent surgery and early systemic pharmacological treatment with teriparatide. Teriparatide is widely used in the treatment of osteoporosis as its anabolic effects promote the deposition of new bone tissue. Associated tibia and fibula fractures have relatively high rates of nonunion and poor long-term outcomes. In this particular case, the fracture had further negative prognostic factors, such as exposure. Two months after the trauma, the radiological healing signs were insufficient, therefore it was decided to use teriparatide, prior to the possible onset of pseudarthrosis, in order to enhance bone healing and promote adequate callus formation. Complete healing of the fracture was achieved after 99 days of treatment. The authors believe that the use of pharmacological aids may be desirable, especially in the presence of risk factors such as complex and open fractures that could seriously slow down the natural regenerative processes of the fractured bone. In this scenario, teriparatide could have an important role in preventing delayed consolidation and improving the healing of nonunion fractures.