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Recent Advances Toward the Clinical Application of PTH (1-34) in Fracture Healing

Image - Photo of David L. Helfet, MD
David L. Helfet, MD
Attending Orthopedic Surgeon, Hospital for Special Surgery
Professor of Orthopaedic Surgery, Weill Cornell Medical College
Image - Photo of Joseph M. Lane, MD
Joseph M. Lane, MD
Attending Orthopedic Surgeon, Hospital for Special Surgery
Professor of Orthopedic Surgery, Weill Cornell Medical College

Cara A. Cipriano
University of Pennsylvania School of Medicine, Philadelphia, PA

Paul S. Issack
Orthopaedic Trauma Service, Hospital for Special Surgery
Orthopaedic Trauma and Adult Reconstructive Surgery, Hospital for Special Surgery

Lisa Shindle
Metabolic Bone Disease Service, Hospital for Special Surgery

Clément M. L. Werner
Orthopaedic Trauma Service, Hospital for Special Surgery

Abstract

PTH 1-34, an active form of parathyroid hormone, has been shown to enhance osteoblastic bone formation when administered as a daily subcutaneous injection. The effect of the intermittent administration of PTH (1-34) is an uncoupling of bone turnover with an increase in bone mass and density and decrease in risk of vertebral and nonvertebral fractures. While PTH (1-34) has been used clinically to increase bone mass and reduce fracture risk in postmenopausal women with osteoporosis, there is increasing evidence that PTH (1-34) may promote fracture healing. Animal studies have demonstrated accelerated callus formation with enhanced remodeling and biomechanical properties of the healing fracture. Given these effects, PTH (1-34) will likely be used clinically to enhance fracture union in poor healing situations such as osteoporosis and recalcitrant nonunions.

This article appears in HSS Journal: Volume 5, Number 2.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.

 

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