Clinical and Radiological Outcomes of Teriparatide Versus Standard Care in Fracture Healing: A Comparative Study on Bone Union, Bone Mineral Density, and Safety

Background: Bone fracture healing is a multifactorial process where conventional conservative treatment of bone fractures with calcium and vitamin D is more about bone mineralisation than enhancement of tissue regeneration. Teriparatide is an artificial parathyroid hormone that acts as an anabolic substance by stimulating the formation of bone through activation of osteoblasts. The current study aimed to compare the effects of teriparatide with those of conventional conservative treatment in patients suffering from bone fractures. Methods: A prospective comparative observational study was carried out for a period of 6 months on 90 subjects. Subjects were divided into two groups; Group A comprised subjects given teriparatide injection (20 mcg per day), and Group B subjects were given normal oral intake of calcium and vitamin D supplements. We monitored clinical and radiological progression at baseline, 4 weeks, 8 weeks, and 12 weeks. Quantification of outcomes was done through various parameters used in the evaluation of bone fracture healing, such as TARHS, TCMI, and BHPS, in addition to the evaluation of bone mineral density (BMD) using dual-energy X-ray absorptiometry. Results: Patients in the teriparatide group demonstrated statistically significant superior outcomes across all validated clinical healing indices compared to the standard care group (p < 0.05). Serial radiographic assessments revealed earlier bridging trabeculae, robust periosteal callus formation, and substantially accelerated structural fracture union in the teriparatide arm. Furthermore, longitudinal assessments indicated a marked increase in local and systemic bone mineral density compared to calcium and vitamin D supplementation alone. Both therapeutic regimens demonstrated favourable safety profiles, with minimal adverse events and high overall patient tolerance. Conclusions: Daily administration of teriparatide provides superior therapeutic efficacy over standard calcium and vitamin D supplementation by significantly shortening union time, promoting robust callus architecture, and elevating bone mineral density. Teriparatide represents an effective osteoanabolic intervention for fracture management, particularly in patients presenting with impaired regenerative capacity or an elevated risk of delayed union.