title: The effect of parathyroid hormone and teriparatide on fracture healing.
abstract: BACKGROUND
  Daily subcutaneous injections of parathyroid hormone (PTH), and its synthetic peptide fragment, teriparatide (PTH 1-34, TPTD), have a net anabolic effect on bone and prevent osteoporotic fractures. TPTD is currently approved for this indication worldwide. Because of the anabolic effect, there is an interest in a role for TPTD (and, where available, human PTH 1-84) in improving bone healing after a fracture. PTH has been studied in animal fracture healing models and in a limited number of human trials. We have reviewed current literature regarding possible mechanisms and efficacy for PTH and TPTD to improve the healing process in the setting of various types of fractures.
  
  
  METHODS
  Our review focuses first on the role of PTH in normal bone. We then discuss mechanisms of normal bone healing as well as delayed and impaired fracture healing. We summarize pertinent animal data and then review human studies utilizing PTH or TPTD for fracture healing. In particular, we examine unique situations including osteoporotic fractures, diabetes, stress fractures, delayed or poor healing and combination with bisphosphonate therapy.
  
  
  CONCLUSIONS
  Available data indicate there is likely an important role for TPTD and PTH in promoting fracture healing in selected patients, but more clinical trial data are needed.
authors.affiliation: University of Calgary, Cumming School of Medicine , 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1 , Canada.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Campbell
authors.forename: Graeme M
authors.initials: GM
authors.lastname: Campbell
authors.forename: David A
authors.initials: DA
authors.lastname: Hanley
mesh_terms: D000818:Animals; D001842:Bone and Bones / Q000187:drug effects; D004164:Diphosphonates / Q000627:therapeutic use; D017102:Fracture Healing / Q000187:drug effects*; D050723:Fractures, Bone / Q000188:drug therapy; D006801:Humans; D010281:Parathyroid Hormone / Q000494:pharmacology* / Q000627:therapeutic use; D010446:Peptide Fragments / Q000627:therapeutic use; D019379:Teriparatide / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D004164:Diphosphonates; D010281:Parathyroid Hormone; D010446:Peptide Fragments; D019379:Teriparatide
keywords: fracture healing; nonunion; parathyroid hormone; teriparatide