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Treatment of fracture non-union in a young adult with combination anabolic and anti-resorptive bone therapy

机译:合成代谢和抗吸收性骨疗法联合治疗年轻人的骨折不愈合

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摘要

Sir, We report successful bone healing following combination treatment with teriparatide and zoledronic acid after a diagnosis of prolonged non-union. A 21-year-old female with extended oligoarticular JIA diagnosed at the age of 8 years sustained a low-impact short oblique closed fracture of her right lower tibia. She had previously received prolonged courses of CSs and was undergoing treatment with MTX, LEF, alendronic acid weekly, calcium and vitamin D supplementation. The fracture failed to unite over 2 years during which conservative management was followed by cortico-cancellous bone autograft, BMP 7 impregnated implant, US stimulation of the fracture site, external fixation and treatment of a staphylococcal infection. She had resection of her non-union with application of an llizarov fixator for bone transport reconstruction of a large bone defect. Unfortunately, the regenerated bone was of very poor quality with no visible calcification on X-ray.
机译:主席先生,我们报告在诊断为长期不愈合后,联合使用特立帕肽和唑来膦酸成功治疗了骨。一名21岁的女性,在8岁时被诊断为患有伸直性小关节JIA,其右下胫骨发生了低冲击力短斜闭合闭合骨折。她以前接受过长时间的CS治疗,并且正在接受MTX,LEF,阿仑膦酸每周,钙和维生素D的补充治疗。骨折在过去2年中未能统一,在此期间保守治疗,随后进行了皮质-松质骨自体移植,BMP 7浸渍的植入物,US刺激骨折部位,外固定和葡萄球菌感染的治疗。她通过应用llizarov固定器切除了不愈合的骨,从而重建了大骨缺损。不幸的是,再生的骨头质量很差,在X射线上没有可见的钙化。

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