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Bisphosphonates do not delay fracture healing in osteoporotic women


Bisphosphonates (BPs) have an inhibitory effect on bone resorption by osteoclasts, which gives them the potential to reduce fracture healing. Gong et al. followed 50 women aged over 50 who had sustained an osteoporosis-related fracture of their distal radius. All patients had their fracture fixed using a volar locking plate, but 24 were started on BP therapy 2 weeks after surgery while the other 26 began BP treatment 3 months later.

All fractures healed to radiographic union in similar time periods (6.7 weeks in the women taking BPs from 2 weeks after surgery, and 6.8 weeks in the women who started BP therapy later). This randomized controlled trial therefore found no significant difference in the healing of distal radial fractures treated by volar plating between commencement of therapy at 2 weeks or 3 months. The results also demonstrated that the time taken for the fracture to heal did not depend on the fracture type or on the severity of the underlying osteoporosis.

Editor’s comment: There has been ongoing debate about the timing of initiation of BP therapy after fracture, partly due to fears regarding fracture healing and partly due to worries about the effects of rigid fixation. This study suggests that BP therapy makes no difference to fracture healing and so should go some way to alleviating those concerns.

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