title: Radiographic features of teriparatide-induced healing of femoral fractures.
abstract: Teriparatide is a drug that is used to increase bone remodeling, formation, and density for the treatment of osteoporosis. We present three cases of patients with a femoral insufficiency fracture. The patients were administered teripatatide in an attempt to treat severe osteoporosis and to enhance fracture healing. We found several radiographic features around the femoral fractures during the healing period. 1) Callus formation was found at a very early stage in the treatment. Teriparatide substantially increased the unusually abundant callus formation around the fracture site at 2 weeks. Moreover, this callus formation continued for 8 weeks and led to healing of the fracture. 2) Abundant callus formation was found circumferentially around the cortex with a 'cloud-like' appearance. 3) Remodeling of the teriparatide-induced callus formation was found to be part of the normal fracture healing process. After 1 year, normal remodeling was observed on plain radiographs. These findings indicate that teriparatide can be used as an adjuvant therapy in the management of femoral insufficiency fractures.
authors.affiliation: Department of Orthopaedics, Kyoto City Hospital, 1-2 Mibu, higashitakada-cho, Nakagyo, Kyoto, Japan.
authors.forename: Youngwoo
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Orthopaedics, Kyoto City Hospital, 1-2 Mibu, higashitakada-cho, Nakagyo, Kyoto, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Tanaka
authors.affiliation: Department of Orthopaedics, Kyoto City Hospital, 1-2 Mibu, higashitakada-cho, Nakagyo, Kyoto, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tada
authors.affiliation: Department of Orthopaedics, Kyoto City Hospital, 1-2 Mibu, higashitakada-cho, Nakagyo, Kyoto, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kanoe
authors.affiliation: Department of Orthopaedics, Kyoto City Hospital, 1-2 Mibu, higashitakada-cho, Nakagyo, Kyoto, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Shirai
keywords: Callus formation; Femoral fracture; Remodeling; Teriparatide