Surgical outcome of atypical subtrochanteric and femoral fracture related to bisphosphonates use in osteoporotic patients with or without teriparatide treatment.

Yeh WL, Su CY, Chang CW, Chen CH, Fu TS, Chen LH, Lin TY

BMC musculoskeletal disorders13 Dec 2017Cited by 31 (Europe PMC)

PMID29237448PMCIDPMC5729282DOI10.1186/s12891-017-1878-5PepBankPUB-29237448

Summary

BackgroundAtypical subtrochanteric fracture and femoral fracture have been considered to be rare complications related to long-term bisphosphonates use. A reduced bone turnover rate may lead to delayed bone healing. Limited data have revealed that teriparatide treatment may reverse the effect of bisphosphonates and be effective in bone healing.MethodsWe reviewed patients with atypical subtrochanteric and femoral fracture related to bisphosphonates use between January 2008 and December 2014. Thirteen female patients were enrolled. Radiographic findings were compatible with the characteristics of atypical fracture. Surgical intervention was performed for all, and teriparatide use was advised postoperatively. Outcome measures included perioperative results, and clinical and radiographic outcome.ResultsOf the 13 female patients enrolled, 10 had subtrochanteric and 6 had proximal femoral fracture; 3 had bilateral fractures. The mean age of the patients at surgery was 70.15±6.36 years. Most fractures (68.8%) presented prodromal thigh pain. All patients were treated with an intramedullary fixation system without severe complications. The patients were divided into 2 groups based on whether they had received treatment with teriparatide or not. The mean time to bone union was 4.4 months in the teriparatide-treated group, and 6.2 months in the non-teriparatide-treated group (p=0.116). Six patients (75%) in the teriparatide-treated group and 4 (50%) in the non-teriparatide-treated group (p= 0.3) achieved bone union within 6 months. The means of the modified Harris Hip Score and Numerical Rating Scale were significantly better in the teriparatide-treated group at postoperative 6 months. Seven patients had the same ability to walk at the 1-year follow-up as they did before the atypical fracture.ConclusionsTeriparatide treatment in patients with atypical fracture may help in fracture healing, hip function recovery, and pain relief in this reduced bone turnover patient group.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study4

4 results from studies that gave the peptide. 4 results from people.

01HumanObservational studyEfficacy outcome
In women with atypical femoral fractures, bone union times did not differ significantly with teriparatide versus no teriparatide.
In plain wordsIn women with atypical femoral fractures, bone union times did not differ significantly with teriparatide versus no teriparatide.
Peptide
Teriparatide (PTH 1-34)
Outcome
No significant changeTime to bone union
Study
n: not reported in source
Comparator
No teriparatide
Outcome group
Bone and joint · Musculoskeletal
Studied dose
Dose not stated
Measurements
Mean union time
4.4 months
teriparatide
Mean union time
6.2 months
no teriparatide
Source sentences
Summary
The mean time to bone union was 4.4 months in the teriparatide-treated group, and 6.2 months in the non-teriparatide-treated group (p=0.116).
3 context sentences(design, population, supporting numbers)
Summary · context
We reviewed patients with atypical subtrochanteric and femoral fracture related to bisphosphonates use between January 2008 and December 2014.
Summary · context
Surgical intervention was performed for all, and teriparatide use was advised postoperatively.
Summary · context
The patients were divided into 2 groups based on whether they had received treatment with teriparatide or not.
Show in the study text Report a problemFND-2923744801
02HumanObservational studyEfficacy outcome
In women with atypical femoral fractures, union within 6 months did not differ significantly with teriparatide versus no teriparatide.
In plain wordsIn women with atypical femoral fractures, union within 6 months did not differ significantly with teriparatide versus no teriparatide.
Peptide
Teriparatide (PTH 1-34)
Outcome
No significant changeBone union within 6 months
Study
n: not reported in source
Comparator
No teriparatide
Outcome group
Bone and joint · Musculoskeletal
Studied dose
Dose not stated
Measurements
Union
75%
teriparatide
Union
50%
no teriparatide
Source sentences
Summary
Six patients (75%) in the teriparatide-treated group and 4 (50%) in the non-teriparatide-treated group (p= 0.3) achieved bone union within 6 months.
3 context sentences(design, population, supporting numbers)
Summary · context
We reviewed patients with atypical subtrochanteric and femoral fracture related to bisphosphonates use between January 2008 and December 2014.
Summary · context
Surgical intervention was performed for all, and teriparatide use was advised postoperatively.
Summary · context
The patients were divided into 2 groups based on whether they had received treatment with teriparatide or not.
Show in the study text Report a problemFND-2923744802
03HumanObservational studyEfficacy outcome
In women with atypical femoral fractures, teriparatide use was linked to better modified Harris Hip Scores than no teriparatide at postoperative 6 months.
In plain wordsIn women with atypical femoral fractures, teriparatide use was linked to better hip scores than no teriparatide.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseModified Harris Hip Score
Study
n: not reported in source
Comparator
No teriparatide
Outcome group
Bone and joint · Musculoskeletal
Studied dose
Dose not stated
Source sentences
Summary
The means of the modified Harris Hip Score and Numerical Rating Scale were significantly better in the teriparatide-treated group at postoperative 6 months.
3 context sentences(design, population, supporting numbers)
Summary · context
We reviewed patients with atypical subtrochanteric and femoral fracture related to bisphosphonates use between January 2008 and December 2014.
Summary · context
Surgical intervention was performed for all, and teriparatide use was advised postoperatively.
Summary · context
The patients were divided into 2 groups based on whether they had received treatment with teriparatide or not.
Show in the study text Report a problemFND-2923744803
04HumanObservational studyEfficacy outcome
In women with atypical femoral fractures, teriparatide use was linked to better pain ratings than no teriparatide at postoperative 6 months.
In plain wordsIn women with atypical femoral fractures, teriparatide use was linked to better pain ratings than no teriparatide.
Peptide
Teriparatide (PTH 1-34)
Outcome
DecreaseNumerical Rating Scale
Study
n: not reported in source
Comparator
No teriparatide
Outcome group
Pain · Musculoskeletal
Studied dose
Dose not stated
Source sentences
Summary
The means of the modified Harris Hip Score and Numerical Rating Scale were significantly better in the teriparatide-treated group at postoperative 6 months.
3 context sentences(design, population, supporting numbers)
Summary · context
We reviewed patients with atypical subtrochanteric and femoral fracture related to bisphosphonates use between January 2008 and December 2014.
Summary · context
Surgical intervention was performed for all, and teriparatide use was advised postoperatively.
Summary · context
The patients were divided into 2 groups based on whether they had received treatment with teriparatide or not.
Show in the study text Report a problemFND-2923744804

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Version history

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Version 2Current
22 Oct 2026, 02:26 UTC
Study results updated
Version 1
21 Oct 2026, 18:59 UTC
First added · source update from Europe PMC

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Surgical outcome of atypical subtrochanteric and femoral fracture related to bisphosphonates use in osteoporotic patients with or without teriparatide treatment.

Summary

Results from this study4

Version history

Subjects

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Keywords