Zusammenfassung
Anamnese und klinischer Befund: Eine
71-jährige und eine 53-jährige Patientin mit periprothetischer
Fraktur des linken Femurschaftes und ein 18-jähriger Patient
mit Pseudoarthrosenbildung nach linker Unterarmschaftfraktur zeigten einen
verzögerten Heilungsverlauf nach diesen Knochenbrüchen.
Untersuchung: Bei regelmäßigen
Röntgenkontrollen zeigte sich, dass in allen drei Fällen
Osteosynthesen und Spongiosaersatz auch nach mehrfachen Revisionen
nicht zur Frakturheilung führten.
Therapie und Verlauf: Teriparatid in
einer Dosierung von 20 – 60 µg
täglich s. c. für 6 – 10
Wochen verabreicht. Bei allen drei Patienten kam es unter der Therapie
mit Teriparatid schließlich zur stabilen Konsolidierung
der Frakturen.
Folgerung: Die Gabe von Parathormon
kann bei Pseudoarthrosen und verzögerter Frakturheilung
zur Knochenkonsolidierung führen.
Abstract
Case history and clinical findings: Two
women, aged 71 and 53 years with periprosthetic factures of the
left femur and an 18 year old man with a non-union of fracture of
the left radius presented for assessment and treatment.
Investigations: Serial radiographs
showed that osteosynthesis and/or autogenous bone-grafting and
multiple revisions had not resulted in healing of the fractures.
Treatment and clinical course: In all
three patients parathyroid hormone (teriparatide), 20 to 60 g, was
injected subcutaneously once daily for 6 - 10 weeks. Subsequently
a stable consolidation of the bone occurred in all of them.
Conclusion: Administration of parathyroid
hormone can induce stable consolidation of the bone in non-unions
and delayed healing of bone fractures.
Schlüsselwörter
Parathormon - Teriparatid - Knochenfraktur - verzögerte Heilung - Heilversuch
Keywords
parathyroid hormone - teriparatide - bone fracture - delayed healing - off label use
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Prof. Dr. Emil C. Reisinger
Universitätsklinik für Innere
Medizin II
Ernst Heydemannstr. 6
18055 Rostock
Phone: 0381/494-7511
Fax: 0381/494-7509
Email: emil.reisinger@uni-rostock.de
