Effect of alendronate on the healing time of distal radial fractures treated conservatively: An observational study

Title : Effect of alendronate on the healing time of distal radial fractures treated conservatively: An observational study

Abstract:

Although fragility fractures of distal radius are common, osteoporosis treatment requires exploration as attempts to improve post-fracture investigations have been only partially successful. Bisphosphonates may help minimize risk of secondary fractures but being a potent antiresorptive agent, it raises concerns about adverse effects on the healing process.

Objective: This observational study examined the effect of bisphosphonate (alendronate) on the healing of distal radius fractures treated in casts.

Methods: 66 patients aged >45 years admitted to two tertiary care hospitals in Mangalore from May 2014 to September 2016 were the study group. The methodology consisted of purposive sampling from two groups: Control group comprised of 33 patients not on alendronate therapy and Case group comprised 33 patients who were on alendronate therapy as part of prophylaxis for osteoporosis prior to fracture occurrence.  After cast removal, radiographs of the fracture were taken at two-week intervals starting from the 6^th week, till fracture union was seen. At each visit, cortical bridging and range of active movement of the wrist taken using a goniometer. Data was analysed using (SPSS) 17.0 for t-values, p-values and correlations and results were presented in the form of graphs and tables. 

Results: No significant differences were observed in the groups (as per p-values) w.r.t. gender (0.804), age (0.835), time to healing (1.000), dorsiflexion (0.956), palmar flexion (0.670), ulnar deviation (0.441), radial deviation (1.000), supination (0.132) or pronation (0.302). Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score did not differ  >95% between the groups over the analysis period.

Conclusion: It was observed that alendronate administration in distal radius fractures did not appear to delay fracture healing time, radiologically or clinically outcome.

Keywords: fragility fracture, osteoporosis, distal radius, bisphosphonate, alendronate

Biography:

Jabez Gnany graduated medical school from Rajiv Gandhi University of health sciences, Bangalore, India. After which he developed keen interest in trauma and orthopaedics. He completed his postgraduate training in Trauma & Orthopaedics from Father Muller medical College Hospital in 2018. After serving in a trauma centre for a three years, he became an affiliated member of Royal College of Surgeons in Edinburgh in 2022. He pursued MCh in Trauma & Orthopaedics with special interest in soft tissue knee between 2021 to 2023. He currently works as a Registrar in Trauma & Orthopaedics at North Cumbria Integrated Care NHS foundation Trust Carlisle, UK.