Sanjay Sibi, Pradeep P, Raghavendran B, Ahmed Rayeez
Department of Orthopaedics, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India.
J Orthop Case Rep. 2025 Sep;15(9):387-393. doi: 10.13107/jocr.2025.v15.i09.6134.
Teriparatide (TPTD), a recombinant form of the biologically active Parathyroid hormone, has been shown to increase bone mass and prevent fractures by increasing serum calcium levels in response to systemic hypocalcemia. Studies have shown improvements in callus volume and mineralization, bone mineral content, rate of successful union, and strength at fracture sites, and produce a sustained anabolic effect throughout the remodeling phase of fracture healing. The present study was done to evaluate the efficacy of TPTD in hastening fracture healing in elderly patients by clinical, radiological, and biochemical parameters.
A prospective case-control study was done on elderly patients (>55 years) with fractures. Pre-operative bone mineral profile assessed. All fractures were surgically fixed. All patients postoperatively on day 5 were started on injection TPTD 20 mcg daily for 8 weeks. Immediate post-operative radiographs and at 4 weeks, 8 weeks (after completion of TPTD), and 16 weeks were taken to assess the radiological Callus Index score. After completion of 8 weeks, a bone mineral profile was done to assess any biochemical changes in response to TPTD usage. Functional assessment was done with a Visual Analog Scale score and a two-minute walk test. All the results were compared with the non-TPTD group.
The use of TPTD showed improvement in bone mineral content and better functional and radiological outcomes compared to the control group.
Both TPTD and Non-TPTD group patients showed fracture healing, but the duration of healing was significantly shorter in the TPTD group. Functional assessment showed better pain control and an increase in the two-minute walk test distances in the TPTD group.
特立帕肽（TPTD）是生物活性甲状旁腺激素的重组形式，已显示可通过提高血清钙水平来应对全身性低钙血症，从而增加骨量并预防骨折。研究表明，它可改善骨痂体积和矿化、骨矿物质含量、骨折成功愈合率以及骨折部位的强度，并在骨折愈合的整个重塑阶段产生持续的合成代谢作用。本研究旨在通过临床、放射学和生化参数评估特立帕肽在加速老年患者骨折愈合方面的疗效。
对老年骨折患者（>55岁）进行前瞻性病例对照研究。术前评估骨矿物质状况。所有骨折均通过手术固定。所有患者术后第5天开始每日注射20微克特立帕肽，持续8周。术后即刻、4周、8周（特立帕肽注射结束后）和16周拍摄X线片，以评估放射学骨痂指数评分。8周结束后，进行骨矿物质状况评估，以评估使用特立帕肽后的生化变化。采用视觉模拟评分法和两分钟步行试验进行功能评估。所有结果均与未使用特立帕肽的组进行比较。
与对照组相比，使用特立帕肽可改善骨矿物质含量，并获得更好的功能和放射学结果。
特立帕肽组和未使用特立帕肽组患者均实现了骨折愈合，但特立帕肽组的愈合时间明显更短。功能评估显示，特立帕肽组的疼痛控制更好，两分钟步行试验距离增加。
