Parathyroid hormone enhances fracture healing. A preliminary report.
This investigation tested the hypothesis that daily parenterally administered parathyroid hormone (1-34) improves fracture healing. Twenty, 3-month-old, male Sprague Dawley rats weighing approximately 400 g each, underwent the production of closed, unilateral mid-diaphyseal femoral fractures. Animals were divided into two groups of 10; the animals received either a daily subcutaneous injection of delivery vehicle (0.9% saline) or 80 micrograms/kg parathyroid hormone. On Day 21 after fracture the animals were euthanized, the femurs were removed and subjected to biomechanical testing, bone densitometry (dual energy x-ray absorptiometry, peripheral quantitative computed tomography), and histologic examination. Treatment with parathyroid hormone resulted in statistically significant increases in callus area and strength. Histologic examination of the calluses showed an increase in the amount of new bone formed. No differences were observed in the weights of the animals or the sizes of the bones. Values obtained using dual energy x-ray absorptiometry and peripheral quantitative computed tomography indicate an increase in density in the parathyroid hormone treated fractures consistent with the histologic appearance and the findings of increased strength, although these bone density changes did not achieve statistical significance. These results suggest that parenterally administered parathyroid hormone (1-34) may enhance or accelerate normal fracture healing and support the concept that this hormone be tested clinically as a systemic treatment for fractures that are slow to heal.
Holzer
G
G
Department of Orthopaedic Surgery, Mount Sinai School of Medicine, New York, NY, USA.
Majeska
R J
RJ
Lundy
M W
MW
Hartke
J R
JR
Einhorn
T A
TA
D015502:Absorptiometry, Photon; D000818:Animals; D001835:Body Weight; D015519:Bone Density; D002146:Bony Callus / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D002356:Cartilage / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D004548:Elasticity; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D017102:Fracture Healing / Q000187:drug effects*; D005596:Fractures, Closed / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D007279:Injections, Subcutaneous; D008297:Male; D010012:Osteogenesis / Q000187:drug effects / Q000502:physiology; D010281:Parathyroid Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D014677:Pharmaceutical Vehicles; D051381:Rats; D017207:Rats, Sprague-Dawley; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality
D010281:Parathyroid Hormone; D014677:Pharmaceutical Vehicles