Possible benefits of strontium ranelate in complicated long bone fractures.
Osteoporosis drugs are prescribed to prevent fragility fractures, which is the principal aim of the management of osteoporosis. However, if fracture does occur, then it is also important to promote a fast and uneventful healing process. Despite this, little is known about the effect of osteoporosis drugs on bone healing in humans. Strontium ranelate is an osteoporosis agent that increases bone formation and reduces bone resorption and may therefore be beneficial in fracture healing. We report four cases of fracture non-union for up to 20 months. Treatment with strontium ranelate (2 g/day) for between 6 weeks and 6 months appeared to contribute to bone consolidation in the four cases. Animal studies support beneficial effects of strontium ranelate on bone healing via improvement of bone material properties and microarchitecture in the vicinity of the fracture. The clinical cases described herein provide new information on these effects, in the absence of randomized controlled studies on the clinical efficacy of pharmacological treatments in osteoporosis in fracture repair. Further studies are necessary. Fracture healing is an important topic in orthopedic research and is also a concern for patients with postmenopausal osteoporosis. Evidence from case reports and animal studies suggests that strontium ranelate improves bone microarchitecture and accelerates fracture healing. A positive effect of osteoporosis treatments on bone healing is an interesting possibility and merits further clinical research.
Serviço de Ortopedia do Centro Hospitalar Tâmega e Sousa, 4564-007 Penafiel, Portugal. duartealegre@yahoo.com
Duarte Nuno
DN
Alegre
Costa
C
Ribeiro
Carlos
C
Sousa
João
J
Correia
Luís
L
Silva
Luís
L
de Almeida
D000328:Adult; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D017102:Fracture Healing / Q000187:drug effects*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use*; D010027:Osteotomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000188:drug therapy; D013324:Strontium / Q000627:therapeutic use*; D013876:Thiophenes / Q000627:therapeutic use*; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000188:drug therapy
D050071:Bone Density Conservation Agents; D009942:Organometallic Compounds; D013876:Thiophenes; C081587:strontium ranelate; D013324:Strontium