Effect of Teriparatide on Fracture Healing in Intertrochanteric Fractures Treated with Proximal Femoral Nailing: A Prospective Comparative Study

Introduction: Intertrochanteric fractures are common in the elderly and are associated with significant morbidity and delayed functional recovery. Proximal femoral nailing (PFN) is a standard method of fixation; however, fracture healing may be compromised in osteoporotic bone. Teriparatide, an anabolic agent, has been proposed to enhance fracture healing. Aims & Objectives: To evaluate the effect of adjunctive teriparatide therapy on radiological union and functional outcomes in intertrochanteric fractures treated with PFN. Materials & Methods: A prospective randomized comparative study was conducted on 30 patients with intertrochanteric fractures at a tertiary care hospital over a 24-month period. Patients were allocated into two groups: Group A (PFN with teriparatide, n=15) and Group B (PFN alone, n=15). Group A received subcutaneous teriparatide (20 µg/day) starting on postoperative day 7 for 24 weeks. Functional outcomes were assessed using the Visual Analogue Scale (VAS), Lower Extremity Functional Scale (LEFS), and Harris Hip Score (HHS). Radiological assessment included cortical bridging, tip-apex distance (TAD), femoral offset, and neck-shaft angle (NSA). Results: Group A demonstrated significantly earlier fracture union (mean 11.2 weeks) compared to Group B (13.4 weeks). Patients receiving teriparatide showed better pain relief and functional scores during early follow-up (1–3 months, P < 0.05). However, functional outcomes and radiological parameters (TAD, NSA, and femoral offset) were comparable between groups at 6 months (P > 0.05). Complication rates were similar in both groups. Conclusion: Adjunctive teriparatide therapy accelerates biological fracture healing and improves early functional recovery in osteoporotic intertrochanteric fractures treated with PFN, without affecting final structural outcomes or increasing complications. References Boyd HB, Griffin LL. 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