Salvage of a Distal Ulnar Nonunion with Teriparatide Therapy

We present an 80-year-old woman with osteoporosis who sustained a fall, resulting in a closed left distal radius fracture and a grade I open ulna fracture. She underwent open reduction internal fixation. Four months later, the radius healed, but the ulna showed delayed union. Initial bone stimulator therapy was ineffective, and computed tomography scans confirmed nonunion at 6 and 9 months after surgery. Revision surgery was considered, but her treatment was changed to teriparatide, a parathyroid hormone analog that stimulates bone healing. Within 2 months, progressive ulnar healing was noted, avoiding revision surgery. At 15 months, x-rays confirmed full healing, and the patient resumed weight-bearing. This case underscores teriparatide as a promising nonsurgical option for fracture nonunion in osteoporotic patients, meriting further research.