A Comparative Study to Evaluate the Role of Teriparatide in Post-Operative Intertrochanteric Fracture Healing

Abstract

Amit Singh, Swaroop Patel, Amit Kumar Jha, Santosh Kumar Singh and Ankit Chaubey

Background: Intertrochanteric fractures result in serious health problems and decrease health-related quality of life (HRQoL) in geriatric population. Faster time-to-union is important for early return to daily activities and reduction of complications. Teriparatide has been shown to accelerate fracture-healing. Purpose of the present prospective study was to evaluate the effect of teriparatide on the course of intertrochanteric fracture-healing.

Methods: 40 patients of intertrochanteric fractures who underwent surgical intervention between October 2020 and September 2021 were enrolled in this prospective study and followed for minimum of six months. Group A included patients who received teriparatide along with calcium supplementation; patients in Group B received only calcium supplementation postoperatively. Demographics, time-to-union, VAS score, mortalities, and radiographic and functional outcomes between groups were compared.

Results: A significantly shorter time-to-union was found in the teriparatide-treated groups (mean, 9.2 v/s 12 weeks, [P=0.00001]). Regard to Harris hip score [HHS], were significantly better in teriparatide-treated groups at 1 month (mean 79.16 v/s 69.76) [P=0.001]) and 6 month (mean84.1 v/s 75.6) [P=0.001]). Similar inter-group differences were noted when comparing the pain VAS scores at 1month (mean 2.4 v/s 2.9) [P= 0.005]}, 3month(mean 2.05 v/s 2.75) [P=0.001]} and 6 months(mean 0.0 v/s 0.35) [P=0.01])and also significant effectiveness regards to Parker and Palmer mobility score at 1month(mean 6 v/s 4.3 [P=0.001], 3 month (mean 6.9 v/s 5.3) [P=.001]}and 6 month(mean 8.7 v/s 6.8)[P=0.001]}and Pre BMD score (mean-2.3 v/s -3.2) [P=0.16]} and 3 month (mean -2.2 v/s -2.1) [P=0.46]} and at 6month (mean -1.11 v/s -1.4) [P=0.016]}.

Conclusions: Teriparatide shows faster fracture healing and better functional outcome and decreases the pain in the intertrochanteric fracture patients. However, a randomized, large-scale cohort study is still necessary to determine the efficacy of teriparatide in intertrochanteric fractures.

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