Shoulder periprosthetic fracture in elderly patient: a minimally invasive osteosynthesis and "off-label" treatment with teriparatide. A case report and literature review

J Biol Regul Homeost Agents. 2019 Mar-Apr;33(2 Suppl. 1):57-62. XIX Congresso Nazionale S.I.C.O.O.P. Societa' Italiana Chirurghi Ortopedici Dell'ospedalita' Privata Accreditata.

Abstract

A case of shoulder periprosthetic fracture in elderly patient. The patient underwent a minimally invasive osteosynthesis and "off-label" treatment with teriparatide. An 80-year-old woman patient following an accidental fall reported a transverse displaced diaphyseal fracture of the right humerus, distal to the stem of the inverse prosthesis. The patient suffering from severe osteoporosis and chronic ischaemic heart disease. The patient underwent fracture osteosynthesis surgery using a Hoffmann III mono-axial external fixator. Teriparatide administered at a dosage of 20 micrograms/day, for four months. At six months from the beginning of th e hybrid treatment, a complete healing of the fracture was observed radiologically and clinically. It is possible to affirm that the use of teriparatide off-label has a positive and additive effect in promoting the healing of fractures.

Keywords: fracture healing; minimally invasive; periprosthetic fracture; teriparatide.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Female
  • Fracture Fixation, Internal*
  • Fracture Healing
  • Humans
  • Minimally Invasive Surgical Procedures
  • Off-Label Use
  • Periprosthetic Fractures / surgery*
  • Periprosthetic Fractures / therapy*
  • Shoulder / surgery
  • Shoulder Injuries / surgery
  • Shoulder Injuries / therapy
  • Teriparatide / therapeutic use*

Substances

  • Teriparatide