title: Atypical femoral fracture in an osteogenesis imperfecta patient successfully treated with teriparatide.
abstract: OBJECTIVE
  We report a case of a successfully healed atypical femoral fracture (AFF) following treatment with teriparatide in a patient with osteogenesis imperfecta (OI). To our knowledge, no successful treatment of AFFs with teriparatide in this subpopulation has ever been described.
  
  
  METHODS
  This is a case report of an AFF treated with teriparatide.
  
  
  RESULTS
  The patient was treated with hormone replacement therapy for 18 years and bisphosphonates for 9 years before suffering a spontaneous AFF in the form of a dislocated noncomminute transverse fracture of the right femoral shaft, and an open reduction and internal fixation (ORIF) with a T2 Femoral Nail was done. Due to nonunion and another fracture distal to the nail, the patient was reoperated on with exchange ORIF and off-label treatment with teriparatide 20 μg/day was started. An X-ray 1 month later showed early signs of fracture healing. A subsequent X-ray 6 months after the last operation showed a solid healing of both right femoral fractures.
  
  
  CONCLUSIONS
  This is a rare case that highly suggests a potential fracture healing effect of teriparatide treatment and highlights a potential significant practical therapeutic consideration in relation to the management of AFF with delayed healing.
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital Hvidovre.
authors.forename: Jakob
authors.initials: J
authors.lastname: Holm
authors.affiliation: Department of Cardiology, Nephrology, and Endocrinology, Copenhagen University Hospital Nordsjælland and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Pia
authors.initials: P
authors.lastname: Eiken
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital Hvidovre.
authors.forename: Lars
authors.initials: L
authors.lastname: Hyldstrup
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital Hvidovre.
authors.forename: Jens-Erik Beck
authors.initials: JE
authors.lastname: Jensen