Early Initiation of Bisphosphonate Does Not Affect Healing and Outcomes of Volar Plate Fixation of Osteoporotic Distal Radial Fractures

Gong, Hyun Sik; Song, Cheol Ho; Lee, Young Ho; Rhee, Seung Hwan; Lee, Hyukjin; Baek, Goo Hyun

doi:10.2106/jbjs.k.01434

Cited by 82 publications

(69 citation statements)

References 33 publications

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“…Most of the studies found no adverse effect of bisphosphonate on fracture healing. Gong et al 23 with a similar study design to ours, reported that ALN administration two weeks following surgery using locking plate and screws did not affect radiological or clinical outcomes of fracture healing in osteoporotic patients. The incidence of osteoporosis in patients with fragility fractures of the distal radius is reported to range from 30% to 47%, [39][40][41] and several fragility fractures, including at the distal radius, occur when the BMD is in the osteopenic range.…”

Section: Discussionsupporting

confidence: 60%

“…Previous studies on the effect of bisphosphonate on fracture healing in humans have reported inconsistent results, [17][18][19][20][21][22][23] which may arise from differences in study design, primary outcome measures, the bisphosphonate used and fracture site studied. Most of the studies found no adverse effect of bisphosphonate on fracture healing.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16] Human studies on the effect of bisphosphonate administration on the healing of acute fractures have yielded inconsistent results. [17][18][19][20][21][22][23] We have undertaken a multicentre, prospective clinical trial to test whether early administration of the bisphosphonate alendronate (ALN) delayed radiological and clinical healing after surgery for distal radial fragility fractures regardless of the bone mineral density (BMD) measured at the lumbar spine. Our hypothesis was that early ALN administration would have no apparent adverse effects on radiologically assessed fracture union.…”

mentioning

confidence: 99%

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Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time

Uchiyama

Itsubo

Nakamura

et al. 2013

The Bone & Joint Journal

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time

Uchiyama

Itsubo

Nakamura

et al. 2013

The Bone & Joint Journal

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“…Thus, an increased time of healing was noted with bisphosphonate use, but that was deemed not satisfactory enough to demonstrate a clinical significance. Gong et al [16] conducted a study in 2012 to determine the effect of early administration of bisphosphonate on the healing of osteoporotic distal radius fractures. This study focused on a randomized clinical trial to determine how safe it is for a patient who has an acute distal radius fracture to be administered bisphosphonates.…”

Section: Discussionmentioning

confidence: 99%

Effect of Alendronate on the Healing Time of Distal Radial Fractures Treated Conservatively: An Observational Study

Koshy

Pinto

Sujir

et al. 2017

Asian J Pharm Clin Res

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Objective: Although fragility fractures of the distal radius are common, osteoporosis treatment requires exploration as attempts to improve postfracture investigations have been only partially successful. Bisphosphonates may help minimize the risk of secondary fractures but being a potent antiresorptive agent; it raises concerns about adverse effects on the healing process. This observational study examines the effect of bisphosphonate (alendronate) on healing of acute fractures of distal radius through 66 patients aged >45 years admitted to two tertiary care hospitals in Mangalore from May 2014 to September 2016. Methods:The methodology consists of purposive sampling from two groups: Control having 33 patients not on alendronate therapy and cases comprising 33 who are on alendronate as part of prophylaxis for osteoporosis before fracture occurrence, with outpatient reviews at 2-week intervals starting from the 6 th till fracture union seen. At each visit, plain radiographs of the involved wrist were taken to yield time to cortical bridging, with range of active movement of the affected wrist taken using a goniometer. Data were analyzed using Statistical Package for the Social Sciences software version 17.0 for t values, p values and correlations and results were presented in the form of graphs and tables.Results: No significant differences were observed in the groups (as per p values) w.r.t. gender (0.804), age (0.835), time to healing (1.000), dorsiflexion (0.956), palmar flexion (0.670), ulnar deviation (0.441), radial deviation (1.000), supination (0.132), or pronation (0.302). Quick Disabilities of the Arm, Shoulder and Hand score did not differ by >95% between the groups over the analysis period. Conclusion:It was observed that alendronate administration in distal radius fractures did not appear to delay fracture healing times radiologically or clinically.

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“…After reset, although the structure can be supported by the palmar plate, the repair of the articular surface will still be affected by the wrist stress, especially in elderly patients with osteoporosis and those with unstable comminuted fractures involving the articular surface due to violent injury (Day and Daly, 2012;Padegimas and Osei, 2013). For patients with serious bone defects, postoperative autologous or artificial bone grafting could effectively restore the radial length and prevent the postoperative collapse of the articular surface (Ozer et al, 2011;Gong et al, 2012;Hegde et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of external fixator combined with T-plate internal fixation for the treatment of comminuted distal radius fractures

et al. 2015

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ABSTRACT. This study compared the efficacy between external fixator combined with palmar T-plate internal fixation and simple plate internal fixation for the treatment of comminuted distal radius fractures. A total of 61 patients classified as type C according to the AO/ASIF classification underwent surgery for comminuted distal radius fractures. There were 54 and 7 cases of closed and open fractures, respectively. Moreover, 19 patients received an external fixator combined with T-plate internal fixation, and 42 received simple plate internal fixation. All patients were treated successfully during 12-month postoperative follow-up. The follow-up results show that the palmar flexion and dorsiflexion of the wrist, radial height, and palmar angle were significantly better in those treated with the external fixator combined with T-plate compared to those treated with the simple plate only (P < 0.05); however, there were no significant differences in radial-ulnar deviation, wrist range of motion, or wrist function score between groups (P > 0.05). Hence, the effectiveness of external fixator combined with T-plate internal fixation for the treatment of comminuted distal radius fractures was satisfactory. Patients sufficiently recovered wrist, forearm, and hand function. Treatment of comminuted distal radius fracturesIn conclusion, compared to the simple T-plate, the external fixator combined with T-plate internal fixation can reduce the possibility of the postoperative re-shifting of broken bones and keep the distraction of fractures to maintain radial height and prevent radial shortening.

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Early Initiation of Bisphosphonate Does Not Affect Healing and Outcomes of Volar Plate Fixation of Osteoporotic Distal Radial Fractures

Abstract: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Cited by 82 publications

References 33 publications

Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time

Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time

Effect of Alendronate on the Healing Time of Distal Radial Fractures Treated Conservatively: An Observational Study

Effectiveness of external fixator combined with T-plate internal fixation for the treatment of comminuted distal radius fractures

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