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Holm J, Eiken P, Hyldstrup L, et al. Atypical femoral fracture in an osteogenesis imperfecta patient successfully treated with teriparatide. Endocr Pract. 2014;20(10):e187-90doi: 10.4158/EP14141.CR.
Holm, J., Eiken, P., Hyldstrup, L., & Jensen, J. E. (2014). Atypical femoral fracture in an osteogenesis imperfecta patient successfully treated with teriparatide. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 20(10), e187-90. https://doi.org/10.4158/EP14141.CR
Holm, Jakob, et al. "Atypical femoral fracture in an osteogenesis imperfecta patient successfully treated with teriparatide." Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists vol. 20,10 (2014): e187-90. doi: https://doi.org/10.4158/EP14141.CR
Holm J, Eiken P, Hyldstrup L, Jensen JE. Atypical femoral fracture in an osteogenesis imperfecta patient successfully treated with teriparatide. Endocr Pract. 2014 Oct;20(10):e187-90. doi: 10.4158/EP14141.CR. PMID: 24936568.
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Endocr Pract. 2014 Oct;20(10):e187-90. doi: 10.4158/EP14141.CR.

Atypical femoral fracture in an osteogenesis imperfecta patient successfully treated with teriparatide.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

Jakob Holm, Pia Eiken, Lars Hyldstrup, Jens-Erik Beck Jensen

Affiliations

  1. Department of Endocrinology, Copenhagen University Hospital Hvidovre.
  2. Department of Cardiology, Nephrology, and Endocrinology, Copenhagen University Hospital Nordsjælland and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.

PMID: 24936568 DOI: 10.4158/EP14141.CR

Abstract

OBJECTIVE: We report a case of a successfully healed atypical femoral fracture (AFF) following treatment with teriparatide in a patient with osteogenesis imperfecta (OI). To our knowledge, no successful treatment of AFFs with teriparatide in this subpopulation has ever been described.

METHODS: This is a case report of an AFF treated with teriparatide.

RESULTS: The patient was treated with hormone replacement therapy for 18 years and bisphosphonates for 9 years before suffering a spontaneous AFF in the form of a dislocated noncomminute transverse fracture of the right femoral shaft, and an open reduction and internal fixation (ORIF) with a T2 Femoral Nail was done. Due to nonunion and another fracture distal to the nail, the patient was reoperated on with exchange ORIF and off-label treatment with teriparatide 20 μg/day was started. An X-ray 1 month later showed early signs of fracture healing. A subsequent X-ray 6 months after the last operation showed a solid healing of both right femoral fractures.

CONCLUSION: This is a rare case that highly suggests a potential fracture healing effect of teriparatide treatment and highlights a potential significant practical therapeutic consideration in relation to the management of AFF with delayed healing.

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