Combined effect of teriparatide and low-intensity pulsed ultrasound for nonunion: a case report

BMC Research Notes

Hiroaki Kijima¹  Hidetomo Saito¹  Yuji Kasukawa¹  Michio Hongo¹  Shin Yamada¹  Naohisa Miyakoshi¹  Yoichi Shimada¹  Koji Nozaka¹ 

[1] Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan

关键词: Bone quality;    Nonunion;    Low-intensity pulsed ultrasound (LIPUS);    Teriparatide;   

Others  :  1132695
DOI  :  10.1186/1756-0500-7-317

 received in 2014-03-05, accepted in 2014-05-21,  发布年份 2014

【 摘 要 】

Background

Low-intensity pulsed ultrasound is a pain-free therapy performed daily at home by the patient and has been shown to promote fracture healing. Teriparatide is a parathyroid hormone preparation that activates osteoblastic bone formation and is also reported to be effective in promoting bony union.

Case presentation

We report the case of a 56-year-old Japanese male with a femoral shaft fracture who underwent intramedullary osteosynthesis nailing initially. He had no radiologic or clinical sign of healing 3 months later and low-intensity pulsed ultrasound was initiated at that time. He was reassessed in another 3 months, with evidence of mild bone consolidation but the fracture gap persisted. Subsequent treatment with human parathyroid hormone was initiated in combination with low-intensity pulsed ultrasound. Full fracture healing was present 6 months after beginning the combination low-intensity pulsed ultrasound and teriparatide. It is hypothesized that the potential additive effects of low-intensity pulsed ultrasound and teriparatide therapy ultimately triggered sufficient bone formation to support osseous union.

Conclusion

The case reported herein is a femoral shaft atrophic nonunion in which traditional interventions failed. Successful fracture healing was finally achieved with low-intensity pulsed ultrasound and teriparatide therapy. This is the first reported case of diaphyseal nonunion with deterioration of bone quality in long bones resolved with teriparatide and low-intensity pulsed ultrasound.

【 授权许可】

   
2014 Nozaka et al.; licensee BioMed Central Ltd.

【 图 表 】

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