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Parathyroid Hormone

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Fragility Fractures of the Pelvis

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Abstract

Parathyroid hormone (PTH) plays various important roles in calcium homeostasis and in bone remodeling. PTH induces its biological effects by regulation of gene expression. The intermittent administration of recombinant human PTH has been shown to stimulate bone formation to a higher extent than bone resorption. PTH 1–34 decreases the risk of vertebral and non-vertebral fractures; increases vertebral, femoral, and total-body BMD. PTH promotes hard callus formation and increases bone strength at the site of the fracture. PTH stimulates the proliferation of osteoprogenitor cells and production of alkaline phosphatase and bone matrix proteins that contribute to hard callus formation. PTH promotes osteoclastogenesis by restoring the original shape, structure, and mechanical strength of the bone. Up to date, there are only few published clinical reports studying the effects of PTH on healing of fractures in humans. There are some case reports published that support a beneficial role of PTH use on delayed-unions or non-unions after fractures. We studied the effect PTH 1–84 on the healing course of 65 osteoporotic pubic fractures. Healing at 8 weeks-follow-up was 100% in the PTH group compared to 9.1% in the control group. Patients in the PTH group had significant improvement in functional outcome compared to the control group. Additional results from well-designed and executed clinical studies are needed to clarify the potential effect of PTH on fracture healing in humans.

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Author information

Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Medical University of Graz, Auenbruggerplatz 1, 8036, Graz, Austria

    Lukas A. Holzer M.D.

  2. Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18–20, 1090, Vienna, Austria

    Gerold Holzer M.D.

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  1. Lukas A. Holzer M.D.
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  2. Gerold Holzer M.D.
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Editor information

Editors and Affiliations

  1. Department of Orthopaedics and Traumatology, University Medical Centre, Johannes Gutenberg-University, Mainz, Germany

    Pol Maria Rommens

  2. Department of Traumatology and Orthopaedics, Westpfalz-Clinics Kaiserslautern, Kaiserslautern, Germany

    Alexander Hofmann

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Holzer, L.A., Holzer, G. (2017). Parathyroid Hormone. In: Rommens, P., Hofmann, A. (eds) Fragility Fractures of the Pelvis. Springer, Cham. https://doi.org/10.1007/978-3-319-66572-6_22

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  • DOI: https://doi.org/10.1007/978-3-319-66572-6_22

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-66570-2

  • Online ISBN: 978-3-319-66572-6

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