title: The administration of intermittent parathyroid hormone affects functional recovery from trochanteric fractured neck of femur: a randomised prospective mixed method pilot study.
abstract: OBJECTIVE
  We wished to assess the feasibility of a future randomised controlled trial of parathyroid hormone (PTH) supplements to aid healing of trochanteric fractures of the hip, by an open label prospective feasibility and pilot study with a nested qualitative sub study. This aimed to inform the design of a future powered study comparing the functional recovery after trochanteric hip fracture in patients undergoing standard care, versus those who undergo administration of subcutaneous injection of PTH for six weeks.
  
  
  METHODS
  We undertook a pilot study comparing the functional recovery after trochanteric hip fracture in patients 60 years or older, admitted with a trochanteric hip fracture, and potentially eligible to be randomised to either standard care or the administration of subcutaneous PTH for six weeks. Our desired outcomes were functional testing and measures to assess the feasibility and acceptability of the study.
  
  
  RESULTS
  A total of 724 patients were screened, of whom 143 (20%) were eligible for recruitment. Of these, 123 were approached and 29 (4%) elected to take part. However, seven patients did not complete the study. Compliance with the injections was 11 out of 15 (73%) showing the intervention to be acceptable and feasible in this patient population.
  
  
  CONCLUSIONS
  Only 4% of patients who met the inclusion criteria were both eligible and willing to consent to a study involving injections of PTH, so delivering this study on a large scale would carry challenges in recruitment and retention. Methodological and sample size planning would have to take this into account. PTH administration to patients to enhance fracture healing should still be considered experimental. Cite this article: Bone Joint J 2016;98-B:840-5.
authors.affiliation: Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK.
authors.forename: T J S
authors.initials: TJ
authors.lastname: Chesser
authors.affiliation: Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK.
authors.forename: R
authors.initials: R
authors.lastname: Fox
authors.affiliation: Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK.
authors.forename: K
authors.initials: K
authors.lastname: Harding
authors.affiliation: Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK.
authors.forename: R
authors.initials: R
authors.lastname: Halliday
authors.affiliation: Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK.
authors.forename: S
authors.initials: S
authors.lastname: Barnfield
authors.affiliation: Kadoorie Research Centre, John Radcliffe Hospital, Headley Way, Oxford OX9 3DU, UK.
authors.forename: K
authors.initials: K
authors.lastname: Willett
authors.affiliation: University of Oxford, Windmill Road, Oxford OX3 7LD, UK.
authors.forename: S
authors.initials: S
authors.lastname: Lamb
authors.affiliation: Stoke Mandeville Hospital, Aylesbury HP21 8AL, UK.
authors.forename: C
authors.initials: C
authors.lastname: Yau
authors.affiliation: University of Oxford, Windmill Road, Oxford OX3 7LD, UK.
authors.forename: M K
authors.initials: MK
authors.lastname: Javaid
authors.affiliation: Royal Victoria Infirmary, Newcastle-upon-Tyne, UK.
authors.forename: A C
authors.initials: AC
authors.lastname: Gray
authors.affiliation: University Hospitals Coventry and Warwick, Coventry, UK.
authors.forename: J
authors.initials: J
authors.lastname: Young
authors.affiliation: University of Bristol NHS Foundation Trust, Education Centre, Level 3, Maudlin Street, Bristol BS2 8AE, UK.
authors.forename: H
authors.initials: H
authors.lastname: Taylor
authors.affiliation: Kadoorie Research Centre, John Radcliffe Hospital, Headley Way, Oxford OX9 3DU, UK.
authors.forename: K
authors.initials: K
authors.lastname: Shah
authors.affiliation: University of Bristol NHS Foundation Trust, Education Centre, Level 3, Maudlin Street, Bristol BS2 8AE, UK.
authors.forename: R
authors.initials: R
authors.lastname: Greenwood
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D005260:Female; D005265:Femoral Neck Fractures / Q000628:therapy*; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D055118:Medication Adherence; D058866:Osteoporotic Fractures / Q000628:therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D012646:Self Administration; D019379:Teriparatide / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D019379:Teriparatide
keywords: Parathyroid hormone; Trochanteric hip fracture