Abstract
BackgroundOsteoporosis is a common complication of acute fracture, which can lead to fracture delayed union or other complications and resulting in poor fracture healing. Bisphosphate is a common anti-osteoporosis drug, but its application in fracture patients is still controversial because of its inhibitory effect on bone resorption.MethodStudies were acquired from literature databases in accordance with established inclusion criteria. Standard mean difference (SMD) and 95% confidence intervals (Cls) were calculated to evaluate the effectiveness of the bisphosphonates treatment in fracture patients. Data analysis was conducted with the Review Manager 5.4.1 software.ResultsA total of 16 studies involving 5022 patients obtained from selected databases were examined. As expected, bisphosphate had no significant effect on fracture healing time, but it could significantly increase BMD and prevent osteoporosis. Meanwhile, bisphosphate can inhibit both bone resorption and bone formation markers, resulting in low bone turnover state.ConclusionThis meta-analysis showed that bisphosphonate have no significant effect on fracture healing time but they do increase the changes in BMD and reduce bone synthesis and resorption markers. Early application of bisphosphonates after injury in the appropriate patient population should be considered.
Highlights
Osteoporosis is a common orthopedic process that increases the incidence of pathologic fractures
Our analysis found that post traumatic/postoperative application of BPs has no significant effect on fracture healing time which differs from previous studies [56] (SMD=0.17, 95% CI : −0.09 to 0.42, p=0.21)
Our meta-analysis showed that compared with placebo, BPs significantly increased the bone mineral density (BMD) in patients with fractures
Summary
Osteoporosis is a common orthopedic process that increases the incidence of pathologic fractures. There are 8.9 million osteoporotic fractures per year worldwide [1]. Disuse osteopenia of the affected extremity can occur within a few months of acute fractures. Most significant bone density loss is often found in the hips and vertebral bodies. Such bone density loss can result in osteoporosis in patients with pre-existing osteopenia or risk factors. Osteoporosis is a common complication of acute fracture, which can lead to fracture delayed union or other complications and resulting in poor fracture healing. Bisphosphate is a common anti-osteoporosis drug, but its application in fracture patients is still controversial because of its inhibitory effect on bone resorption
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