Published online Sep 26, 2019. doi: 10.12998/wjcc.v7.i18.2838
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
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.
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.
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.