Teriparatide improves early callus formation in distal radial fractures.
Teriparatide improves early callus formation in distal radial fractures.
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DOI：
10.3109/17453671003761946
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发表时间：
2010-04
影响因子：
3.7
通讯作者：
Johansson T
中科院分区：
文献类型：
--
作者：
Aspenberg P;Johansson T
背景 特立帕肽（甲状旁腺激素；PTH 1-34）可增加人类骨骼质量并改善动物骨折愈合。最近一项针对非手术远端桡骨骨折的随机多中心试验显示，每日 20 μg（低剂量）特立帕肽治疗可适度缩短恢复皮质连续性的时间，但 40 μg（高剂量）则不会。由于射线照相皮质连续性出现在愈合过程的后期，对于临床相关性来说可能为时已晚，因此我们研究了骨折后 5 周愈伤组织的定性外观。方法 国际试验中三分之一的患者在林雪平大学医院接受治疗。多中心试验没有评估早期愈伤组织的形成。因此，我们在 5 周时对 27 名患者的愈伤组织进行了盲法定性评分。愈伤组织形成被任意分类为丰富、中等或较差。结果 9 名患者被归类为富有（没有人接受安慰剂，3 名患者接受低剂量特立帕肽，6 名患者接受高剂量特立帕肽）。 9 名患者被分类为中间（1 名接受安慰剂，5 名低剂量，3 名高剂量）。 9 名患者被分类为较差（7 名患者接受安慰剂，1 名低剂量患者，1 名高剂量患者）（p < 0.001）。解释 这是对结果变量的事后亚组分析，官方方案中没有该分析。因此必须谨慎解释结果。然而，结合更大规模试验的结果，数据表明早期时间点的放射线照相质量可能是一个敏感变量，可能比皮质连续性的时间更好。此外，特立帕肽似乎可以改善远端桡骨骨折的早期骨痂形成。
Background Teriparatide (parathyreoid hormone; PTH 1-34) increases skeletal mass in humans and improves fracture healing in animals. A recent randomized multicenter trial of nonoperated distal radial fractures showed a moderate shortening of the time to restoration of cortical continuity by treatment with 20 μg (low-dose) teriparatide per day, but not with 40 μg (high-dose). As radiographic cortical continuity appears late in the healing process, perhaps too late for clinical relevance, we studied the qualitative appearance of the callus 5 weeks after fracture. Methods One third of the patients of the international trial were treated at Linköping University Hospital. The multicenter trial did not evaluate early callus formation. We therefore made a blinded qualitative scoring of the callus at 5 weeks in our 27 patients. Callus formation was arbitrarily classified as rich, intermediate, or poor. Results 9 patients were classified as rich (none had received placebo, 3 low-dose teriparatide, and 6 high-dose teriparatide). 9 patients were classified as intermediate (1 had received placebo, 5 low-dose, and 3 high-dose). 9 patients were classified as poor (7 had received placebo, 1 low-dose, and 1 high-dose) (p < 0.001). Interpretation This is a post hoc subgroup analysis of an outcome variable, which was not in the official protocol. The results must therefore be interpreted with caution. However, in combination with the results of the larger trial, the data suggest that radiographic quality at an early time point might be a sensitive variable, perhaps better than time to cortical continuity. Moreover, teriparatide appeared to improve early callus formation in distal radial fractures.
影响因子：
4.1
作者：
Goldhahn, Joerg;Scheele, Wim H.;Reginster, Jean-Yves
通讯作者：
Reginster, Jean-Yves
DOI：
10.1302/0301-620x.82b1.9729
发表时间：
2000-01-01
影响因子：
--
作者：
Skripitz, R;Andreassen, TT;Aspenberg, P
通讯作者：
Aspenberg, P
DOI：
10.1080/00016470410004012
发表时间：
2004-12-01
期刊：
ACTA ORTHOPAEDICA SCANDINAVICA
影响因子：
--
作者：
Skripitz, R;Aspenberg, P
通讯作者：
Aspenberg, P