Teriparatide as a non-surgical salvage therapy for prolonged humerus fracture nonunion: A case report and literature review

Background: Fracture nonunion represents a challenging complication during fracture repair, often necessitating surgical intervention. Teriparatide, a recombinant human parathyroid hormone, has demonstrated promise in enhancing fracture healing, although its efficacy in treating established nonunion remains under investigation.

Case summary: We report a case of a 27-year-old male who presented with a right humerus fracture following a traffic accident. Despite undergoing open reduction and internal fixation, the fracture resulted in a delayed union and subsequent nonunion. After 4 years of conservative management, teriparatide treatment was initiated due to persistent nonunion. Teriparatide injections were administered daily for 6 months, resulting in complete fracture healing and resolution of pain.

Conclusion: Our case demonstrates the successful use of teriparatide in treating a prolonged nonunion of a humerus fracture. Teriparatide may provide a valuable therapeutic option for established bone nonunion, even in cases that have not responded to conservative treatments.