Would you consider the use of an anabolic agent to promote fracture healing?

While there are no drugs FDA that are approved to enhance fracture healing, there is considerable literature and experience using the PTH-based anabolic drugs to attempt to heal a fracture. They are sometimes used in the setting of delayed union or non-union. They have been used in elite athletes to hasten the return to sport after a fracture.

One of the better studies done with teriparatide was a pelvic fracture study done at a single site in Austria. The patients who received teriparatide had more rapid radiographic healing and had more rapid functional improvement measured by Time Up and Go. Most patients with pelvic fracture have osteoporosis so it is not a huge leap to initiate a PTH-based anabolic for osteoporosis and hope it may hel...

You hit all the important points, with cost and consequent insurance approval always the greatest obstacle!