Article
Teriparatide treatment in elderly patients with sacral insufficiency fracture
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Published: | October 23, 2017 |
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Objectives: Pain-related immobility due to insufficiency fractures may result in serious complications and a high mortality rate in senile patients with pre-existing comorbidities. We evaluated the efficacy of teriparatide in patients with sacral insufficiency fractures.
Methods: Forty-one patients underwent radiographs, magnetic resonance imaging and/or bone scans to document sacral insufficiency fractures. Of these 41 patients, 21 received once-daily subcutaneous treatment with teriparatide within 2 days after admission to the hospital, and 20 patients who did not receive teriparatide treatment served as the control group. Functional outcome was assessed using a visual analog scale for pain and the time to mobilization. Pelvic AP radiographs were repeated at 0, 1, 4, 8, 12 and 16 weeks until radiographic evidence of cortical bridging at the fracture site was confirmed.
Results and Conclusion: From the date of admission to 4 weeks, the mean VAS score improved from 6.9 to 3.8 in the teriparatide treatment group and from 6.5 to 5.1 in the control group. The mean time to fracture healing was 10.6 weeks in the treatment group, compared with 13.6 weeks in the control group (p < 0.001). At 8 weeks, all fractures in the treatment group were healed and four fractures in the control group were healed (healing rate, 100% compared with 10%; p < 0.001).
In patients in this population who have sacral insufficiency fractures, teriparatide treatment may archive earlier pain reduction and mobilization, and reduce healing time.