title: Influence of Early Bisphosphonate Administration for Fracture Healing in Patients with Osteoporotic Proximal Humerus Fractures.
abstract: BACKGROUND
  Bisphosphonates are generally known to adversely affect fracture healing because they inhibit osteoclastic bone resorption. However, some authors argue that bisphosphonates have no adverse effect on the restoration of the mechanical integrity of long bones after fractures. It is unclear whether bisphosphonates can be initiated safely in patients with acute proximal humerus fractures. The aim of this study was to determine whether the early use of a bisphosphonate affects healing and outcomes of osteoporotic proximal humerus fractures treated with a locking compression plate.
  
  
  METHODS
  Between August 2004 and June 2013, a total of 82 osteoporotic patients who underwent locking plate fixation of proximal humerus fractures were enrolled retrospectively. The patients were divided into two groups according to the timing of the commencement of treatment with alendronate after surgery: group A (n = 34, initiation of the bisphosphonate treatment within two weeks after surgery) and group B (n = 48, control group, initiation of the treatment three months after surgery). Patients were assessed for radiographic union at 2, 6, 10, and 16 weeks, 6 months, and 1 year after surgery. Clinical assessments were performed using the Constant score and American Shoulder and Elbow Surgeons (ASES) score at 1 year after surgery.
  
  
  RESULTS
  No significant differences were observed between the two groups with respect to radiographic and clinical outcomes after locking plate fixation. All patients obtained fracture union, and the mean time to radiographic union was similar in group A and group B (6.3 and 6.6 weeks, respectively;p= 0.67).
  
  
  CONCLUSIONS
  This study shows that the early initiation of bisphosphonate treatment does not affect bone union or clinical outcomes in patients with an osteoporotic proximal humerus fracture treated by locking compression plate fixation.
authors.affiliation: Department of Orthopedic Surgery, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Joong-Bae
authors.initials: JB
authors.lastname: Seo
authors.affiliation: Department of Orthopedic Surgery, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Yoo
authors.affiliation: Department of Orthopedic Surgery, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Jee-Won
authors.initials: JW
authors.lastname: Ryu
authors.affiliation: Department of Orthopedic Surgery, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Kun-Woong
authors.initials: KW
authors.lastname: Yu
mesh_terms: D000368:Aged; D004164:Diphosphonates / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D005260:Female; D017102:Fracture Healing / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000188:drug therapy*; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000188:drug therapy*
chemical_list: D004164:Diphosphonates
keywords: Bisphosphonate; Osteoporosis; Proximal humeral fracture