Comparison of radiographic fracture healing in the distal radius for patients on and off bisphosphonate therapy.
OBJECTIVE
To compare healing rates of distal radius fractures in patients on bisphosphonate therapy at the time of injury to rates in those not on bisphosphonate therapy.


METHODS
A total of 196 consecutive patients treated for distal radius fractures were included in this study. Patients currently on bisphosphonate therapy at the time of injury (bisphosphonate group, n = 43) were compared to the remaining patient group (control group, n = 153). Demographic information was recorded from the patients' medical records, and radiographs were reviewed to determine fracture healing. Patients were further stratified according to age, gender, fracture complexity, type of treatment, and comorbidities. Univariate and multivariate regression were used to identify factors associated with time to radiographic fracture union.


RESULTS
The mean time to union was 55 (+/-17) days in the bisphosphonate group versus 49 (+/-14) days in the control group. Bisphosphonate use and surgical treatment were associated with a longer time to radiographic union. Bisphosphonate use was associated with increased healing times when individually controlling for age, gender, fracture complexity, or comorbidities. Bisphosphonate use was also associated with longer time to healing after adjusting for age, gender, and treatment type. Surgical fracture fixation was associated with a longer time to healing after adjusting for bisphosphonate use.


CONCLUSIONS
Current bisphosphonate use and surgical treatment were both associated with longer times to radiographic union of distal radius fractures. However, the small differences in healing times (<1 week) are not considered clinically relevant. Although further studies are needed to better define the effects of bisphosphonate therapy on fracture healing, our results suggest that bisphosphonate therapy can be continued after distal radius fractures without notable deleterious effects.


METHODS
Therapeutic III.
Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. trozenta@bidmc.harvard.edu
Tamara D
TD
Rozental
Michael A
MA
Vazquez
Aron T
AT
Chacko
Nworah
N
Ayogu
Mary L
ML
Bouxsein
D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000627:therapeutic use*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D001858:Bone Nails; D002370:Casts, Surgical; D012968:Etidronic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000187:drug effects*; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging*; D000068296:Risedronic Acid; D013997:Time Factors; D014954:Wrist Injuries / Q000000981:diagnostic imaging*
D050071:Bone Density Conservation Agents; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate