Teriparatide in the treatment of non-unions: scientific and clinical evidences.

Introduction: Each fracture has a failing risk which can lead to a non-union. Among the non-invasive strategies proposed to improve bone healing, also in non-union, the use of teriparatide, a drug for the treatment of the osteoporosis, has increasing supporting data.

Experimental Data: Many studies mainly on rats, but also on primates, demonstrate the positive effect on fracture healing of teriparatide, both in physiological and pathological conditions, with a more rapid evolution of the reparative callus.

Biological and pharmacological factors influencing the fracture healing.

Many experimental data are available about the positive effect of some molecules on fracture repair, but data on their efficacy in the clinical use in humans are still lacking. Bone Morphogenetic Proteins are currently used in the treatment of delayed unions, but it is necessary to insert them surgically in the fracture site. The only pharmacological factor with clinical data is teriparatide, but more data are needed to confirm its effect on fracture healing in humans, even if experimental data in animals are robust.