Parathyroid Hormone 1-34(Teriparatide) Treatment in Pelvic Insufficiency Fractures - A Report of Two Cases -
Eighty two years old female visited outpatient clinic due to the pain on the right buttock that was occurred after a fall (slip down) on her behind. Simple radiograph at the time of her visiting indicated fractures in right pubic ramus and CT scan showed fractures in sacrum left side (). Osteoporosis with T-score -3.3 (L1-4) was observed, but the patient had never diagnosed and treated for osteoporosis before the injury.\nThe patient was injected with 20 µg of teriparatide (1-34 PTH, Forsteo®) subcutaneously once a day for 8 weeks and bed rest and medication for pain relief was combined at the same time; tramadol 50 mg (Tridol®) was injected intravenously twice, morning and night, a day for two weeks and transdermal fentanyl patch 12 µg/hr (Durogesic® DTrans®) was administered every 72 hours for three weeks. VAS was 7 at the time of admission and then decreased to 2 two weeks after the administration (three weeks after the injury). The patient was able to ambulate with a wheelchair three weeks after the injury and walked independently without a walker four weeks after the injury. On simple radiograph four weeks after the injury, callus formation was observed in right pubic ramus and then it was even definitely denser on 3 months follow-up x-ray ().