title: Effective treatment of a steroid-induced femoral neck fracture nonunion with a once-weekly administration of teriparatide in a rheumatoid patient: a case report.
abstract: BACKGROUND
  Nonunion of femoral neck fractures frequently occurs in elderly patients. In patients with rheumatoid arthritis, reoperation rates after internal fixation of a displaced femoral neck fracture increase by up to 60 %. Revision surgery with arthroplasty is often preferred for nonunion of femoral neck fractures because there are few effective options for conservative treatment. Teriparatide (TPTD) is a human parathyroid hormone analog and the only anabolic drug for the treatment of severe osteoporosis.
  
  
  CONCLUSIONS
  There are two types of treatment regimens using TPTD: a once-daily administration of recombinant type TPTD and a once-weekly administration of a chemically synthesized type. Although there have been some reports showing that the once-daily recombinant type TPTD was effective for nonunion treatment, the effect of a once-weekly administration of the chemically synthesized type of TPTD is unknown. This report shows the efficacy of the chemically synthesized TPTD for the treatment of femoral neck fracture nonunion in a patient with risk factors that include rheumatoid arthritis and steroid intake.
authors.affiliation: Department of Orthopedic Surgery, Nagano Hospital, Nippon Telegraph and Telephone East Co. Ltd, 1-2-43 Miwa, Nagano, Japan. yxmitani@hotmail.com
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Mitani
mesh_terms: D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003545:Cysteine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005265:Femoral Neck Fractures / Q000139:chemically induced / Q000188:drug therapy*; D005599:Fractures, Ununited / Q000188:drug therapy*; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy* / Q000209:etiology; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D019379:Teriparatide / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D050071:Bone Density Conservation Agents; D005938:Glucocorticoids; D019379:Teriparatide; D011239:Prednisolone; D003545:Cysteine; C026535:bucillamine
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