الفهرس | Only 14 pages are availabe for public view |
Abstract F ractures often contribute to high mortality and adverse outcomes in the geriatric population. During recovery from fracture, most patients experience fracture reduced mobility and impaired ability to perform routine daily activities, with a large proportion failing to regain their refracture functional level after 1 year. Teriparatide is approved and plays an important role in treating osteoporosis and glucocorticoid-induced osteoporosis in patients at a high fracture risk of fractures. We performed this systemic review and meta-analysis to evaluate the efficacy and safety of teriparatide in improving fracture healing after surgery. Searching process was performed using advanced search strategy on scientific databases. Inclusion criteria were adult patients administrated teriparatide after surgical fixation of fractures. We included all types of study design except case report and case series. The searching and identification process resulted in 16 papers which included in this study. The result could be summarized as follow: Time to union were lower in TPTD group than non-TPTD group. The rates of fracture union after 3 and 6 months were similar in both groups. There were a significant improvement in bone mineral density when using teriparatide more than 6 months after surgical intervention for treatment of fracture. Varus collapse were lower in TPTD group than non-TPTD group. There were a significant improvement in functional outcome when using teriparatide post-operatively. HHS were higher in teriparatide (TPTD) group than non-TPTD group. Incidence of mal-union/nonunion and subsequent fracture were lower in TPTD group than non-TPTD group. Mortality rate were lower in TPTD group than non-TPTD group. Reoperation rate, complications’ rate and deformity rate were similar in TPTD group and non-TPTD group. The use of teriparatide after fractures’ surgical fixation improve functional and radiological outcome and reduce time to union, rate of femoral shortening, degree of varus collapse and mortality rate especially in osteoporotic patients. We recommended the use of teriparatide after fractures’ surgical fixation especially in osteoporotic patients to improve bone mineral density and accordingly to improve functional and radiological outcome and reduce time to union and reduce mortality rate. |