title: Strontium ranelate as an adjuvant for fracture healing: clinical, radiological, and ultrasound findings in a randomized controlled study on wrist fractures.
abstract: This randomized and controlled study evaluated the effect of therapy with strontium ranelate on callus formation in wrist fractures and its incidence in wrist recovery. Radiographic healing, progression of clinical recovery, and callus quality with ultrasound were evaluated. No statistically significant benefit of therapy was found.
  
  
  BACKGROUND
  Fracture prevention is the main goal of any therapy for osteoporosis. Various drugs used in osteoporosis treatment have the theoretical premises to promote fracture healing and osseointegration. In this study, the effect of strontium ranelate on callus formation in wrist fractures was evaluated and whether it could lead to clinically relevant modification of wrist recovery; having strontium ranelate osteoinductive properties, it could be used, if effective, as an adjunct in fracture healing for a faster and functionally better recovery and, at the same time, in starting proper therapy in osteoporotic patients with fragility fractures.
  
  
  METHODS
  We considered only patients older than 60 years who had suffered wrist fracture and received nonoperative treatment with manual reduction of the fracture and cast for 35 days. Forty patients were included and randomly assigned to one of two groups: group A [patients treated with calcium (1200 mg/day) and vitamin D (800 IU/day)] and group B [patients treated with calcium (1200 mg/day) and vitamin D (800 IU/day) associated with strontium ranelate 2 g daily]. Radiographic healing was evaluated through the bone callus formation, cortical continuity, and density of the callus. A clinical evaluation using Castaing's criteria was carried out 2 and 3 months following the fracture together with an ultrasound study of callus density and vessels.
  
  
  RESULTS
  A parametric analysis of the X-ray data, clinical evaluation, and ultrasonography results showed that there were no statistically significant differences in the two groups (p > 0.05 for all data).
  
  
  CONCLUSIONS
  In analyzing the data obtained, we concluded that strontium ranelate administered in acute phase did not improve nor accelerate wrist fracture healing in our population.
authors: Clinica Ortopedica dell'Unversità degli Studi di Pisa, U.O. Ortopedia e Traumatologia II, Via Paradisa 2, Pisa, Italy.
authors: M
authors: M
authors: Scaglione
authors: Clinica Ortopedica dell'Unversità degli Studi di Pisa, U.O. Ortopedia e Traumatologia II, Via Paradisa 2, Pisa, Italy. lucafabbri8@gmail.com.
authors: L
authors: L
authors: Fabbri
authors: Clinica Ortopedica dell'Unversità degli Studi di Pisa, U.O. Ortopedia e Traumatologia II, Via Paradisa 2, Pisa, Italy.
authors: F
authors: F
authors: Casella
authors: Clinica Ortopedica dell'Unversità degli Studi di Pisa, U.O. Ortopedia e Traumatologia II, Via Paradisa 2, Pisa, Italy.
authors: G
authors: G
authors: Guido
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002146:Bony Callus / Q000000981:diagnostic imaging / Q000187:drug effects; D002370:Casts, Surgical; D017024:Chemotherapy, Adjuvant; D005260:Female; D005592:Fracture Fixation / Q000379:methods; D017102:Fracture Healing / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D013876:Thiophenes / Q000627:therapeutic use*; D016896:Treatment Outcome; D014463:Ultrasonography; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000188:drug therapy*
chemical_list: D050071:Bone Density Conservation Agents; D013876:Thiophenes; C081587:strontium ranelate
keywords: Healing adjuvant; Osteoporosis; Strontium ranelate; Ultrasound callus; Wrist fracture