Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time

S. Uchiyama, T. Itsubo, K. Nakamura, Y. Fujinaga, N. Sato, T. Imaeda, M. Kadoya, H. Kato

Abstract

This multicentre prospective clinical trial aimed to determine whether early administration of alendronate (ALN) delays fracture healing after surgical treatment of fractures of the distal radius. The study population comprised 80 patients (four men and 76 women) with a mean age of 70 years (52 to 86) with acute fragility fractures of the distal radius requiring open reduction and internal fixation with a volar locking plate and screws. Two groups of 40 patients each were randomly allocated either to receive once weekly oral ALN administration (35 mg) within a few days after surgery and continued for six months, or oral ALN administration delayed until four months after surgery. Postero-anterior and lateral radiographs of the affected wrist were taken monthly for six months after surgery. No differences between groups was observed with regard to gender (p = 1.0), age (p = 0.916), fracture classification (p = 0.274) or bone mineral density measured at the spine (p = 0.714). The radiographs were assessed by three independent assessors. There were no significant differences in the mean time to complete cortical bridging observed between the ALN group (3.5 months (se 0.16)) and the no-ALN group (3.1 months (se 0.15)) (p = 0.068). All the fractures healed in the both groups by the last follow-up. Improvement of the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, grip strength, wrist range of movement, and tenderness over the fracture site did not differ between the groups over the six-month period. Based on our results, early administration of ALN after surgery for distal radius fracture did not appear to delay fracture healing times either radiologically or clinically.

Cite this article: Bone Joint J 2013;95-B:1544–50.

Footnotes

  • This study is supported by a Univers Foundation Research Grant ‘Aiming toward the healthy and spiritual enriched society’ and grants from the Research Project of the Japanese Society for Surgery of the Hand, the Research Foundation for Community Medicine, the Preventive Medical Center of Shinshu University Hospital, and the Project to Promote Education, Research and Medical Care at Shinshu University Hospital.

    The authors would like to thank Drs S. Matsuda, I. Nakamura, M. Komatsu in Nagano Municipal Hospital, T. Momose, H. Matsuki, H. Shimodaira, S. Takanashi, A. Tanaka in Red Cross Suwa Hospital, S. Aiba, K. Takahara, S. Koyama, K. Hara in Ina Central Hospital, T. Yasutomi in Hokuto Municipal Shiokawa Hospital, M. Kamimura in Kamimura Clinic, S. Ikegami in Shinshu University, M. Kamihira in Kofu Municipal Hospital, K. Shimokawa in Omachi Municipal General Hospital, H. Yamazaki in Aizawa Hospital, T. Takizawa in Nagano Matsushiro General Hospital, H. Kobayashi in Chushin-Matsumoto General Hospital, S. Goto in Fujimi Kogen Hospital, Y. Nakamura in Showa Inan General Hospital for collecting and interpreting the data.

    The author or one or more of the authors have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article. In addition, benefits have been or will be directed to a research fund, foundation, educational institution, or other non-profit organisation with which one or more of the authors are associated.

    This article was primary edited by G. Scott and first-proof edited by D. Rowley.

  • Received January 28, 2013.
  • Accepted July 15, 2013.
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