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Case report
Repurposing denosumab for recalcitrant bone healing
  1. Sanjay Agarwala and
  2. Mayank Vijayvargiya
  1. Orthopedics, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
  1. Correspondence to Dr Sanjay Agarwala; drsa2011{at}gmail.com

Abstract

Fracture healing has four phases: haematoma formation, soft callus, hard callus and remodelling. Often, non-healing fractures have an arrest of one of these phases, which need resurgery. We have repurposed denosumab for impaired fracture healing cases to avoid surgical intervention. Here, we report a series of three cases of impaired fracture healing where denosumab was given 120 mg subcutaneous dosages for 3 months to enhance healing. All the three cases have shown complete bone union at a mean follow-up of 6.7 months (5–9 months) as assessed clinically and radiologically, and have observed no adverse effect of the therapy. Denosumab given in this dose aids fracture healing by increasing callus volume, density and bridges the fracture gap in recalcitrant fracture healing cases where the callus fails to consolidate.

  • drug therapy related to surgery
  • trauma
  • medical management
  • orthopaedics

http://dx.doi.org/10.1136/bcr-2020-238460

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    Footnotes

    • Contributors SRA have contributed to the conception, design, drafting, acquisition, analysis and interpretation of data of the study and have read and approved the final manuscript. MV have contributed to the conception, design, drafting, acquisition, analysis and interpretation of data of the study and have read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Ethics approval Institutional review board approved this study.

    • Provenance and peer review Not commissioned; externally peer reviewed.