title: Teriparatide Treatment in Elderly Patients With Sacral Insufficiency Fracture.
abstract: Pain-related immobility because of insufficiency fractures may result in serious complications and a high mortality rate in senile patients with preexisting comorbidities. This study aimed to evaluate the efficacy of teriparatide in patients with sacral insufficiency fractures.
  
  
  
  This retrospective, case-controlled, single center study, performed from 2009 to 2014, included 41 patients who underwent radiographs, magnetic resonance imaging, and/or bone scans to document sacral insufficiency fractures.
  
  
  
  The intervention involved teriparatide at a once-daily subcutaneous dose of 20 μg within 2 days of hospital admission (21 patients). Twenty patients (control group) did not receive teriparatide.
  
  
  
  Functional outcome was assessed using a visual analog scale for pain and the time to mobilization. Pelvic anteroposterior radiographs were repeated at 0, 1, 4, 8, 12, and 16 weeks until radiographic evidence of cortical bridging at the fracture site was confirmed.
  
  
  
  From the date of admission to 4 weeks, the mean visual analog scale score improved between the 2 groups. The mean time to mobilization was 1.2 ± 0.4 weeks in patients who received teriparatide treatment, compared with 2.0 ± 0.3 weeks in controls (P < 0.001). At 8 weeks, all fractures in the teriparatide treatment group and 4 fractures in the control group had healed.
  
  
  
  In senile patients with preexisting comorbidities who have sacral insufficiency fractures, teriparatide treatment may achieve earlier pain reduction and mobilization and reduce healing time.
authors.affiliation: Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul 06973, Korea.
authors.forename: Jun-Il
authors.initials: JI
authors.lastname: Yoo
authors.affiliation: Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul 06973, Korea.
authors.forename: Yong-Chan
authors.initials: YC
authors.lastname: Ha
authors.affiliation: Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul 06973, Korea.
authors.forename: Hyun-Jun
authors.initials: HJ
authors.lastname: Ryu
authors.affiliation: Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul 06973, Korea.
authors.forename: Geun-Wu
authors.initials: GW
authors.lastname: Chang
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Sungnam 03080, Korea; and.
authors.forename: Young-Kyun
authors.initials: YK
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan 31116, Korea.
authors.forename: Moon-Jib
authors.initials: MJ
authors.lastname: Yoo
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Sungnam 03080, Korea; and.
authors.forename: Kyung-Hoi
authors.initials: KH
authors.lastname: Koo
mesh_terms: D059787:Acute Pain / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000494:pharmacology*; D016022:Case-Control Studies; D005260:Female; D017102:Fracture Healing / Q000502:physiology*; D015775:Fractures, Stress / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D058866:Osteoporotic Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D012189:Retrospective Studies; D012447:Sacrum / Q000293:injuries*; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D019379:Teriparatide / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D050071:Bone Density Conservation Agents; D019379:Teriparatide