Review Article

Differences in union time, dash score and range of motion between giving bisphosphonate and without giving bisphosphonate of osteoporosis patients with distal radius fracture: a systematic review and meta-analysis

Dwiwahyonokusuma Dwiwahyonokusuma , Putu Astawa, I Wayan Suryanto Dusak, I Ketut Suyasa, Made Bramantya Karna

Dwiwahyonokusuma Dwiwahyonokusuma
Resident of Orthopaedics and Traumatology, Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Denpasar, Bali.. Email: nonotjandra@gmail.com

Putu Astawa
Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Denpasar, Bali.

I Wayan Suryanto Dusak
Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Denpasar, Bali.

I Ketut Suyasa
Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Denpasar, Bali.

Made Bramantya Karna
Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Denpasar, Bali.
Online First: April 01, 2021 | Cite this Article
Dwiwahyonokusuma, D., Astawa, P., Dusak, I., Suyasa, I., Karna, M. 2021. Differences in union time, dash score and range of motion between giving bisphosphonate and without giving bisphosphonate of osteoporosis patients with distal radius fracture: a systematic review and meta-analysis. Intisari Sains Medis 12(1): 141-146. DOI:10.15562/ism.v12i1.894


Background: Osteoporosis is a common health problem. Meanwhile, the incidence of distal radius fracture increases with osteoporosis. The standard modality for osteoporosis is a combination of pharmacological therapy, one example of which is the administration of bisphosphonates. There is some disagreement about bisphosphonates' effect on the treatment of distal radius fractures in osteoporosis patients. This study aims to conclude the effect of bisphosphonates for this condition on both functional and radiological outcomes

Methods: A systematic search was carried out on the PUBMED database and Google Scholar on studies comparing the timing of bone fusion, Disability of Arm, Shoulder, And Hand (DASH) scores, and wrist Range of Motion (ROM) among distal radius fracture patients with or without additional bisphosphonate therapy. A prospective or retrospective cohort study and a randomized controlled trial were included in this study during 2000-2020. Inclusion and exclusion criteria were used for sample selection. Weight Mean Difference (WMD) was used to assess the statistical results in RevMan version 5.3 for Windows.

Results: A search through the PUBMED and Google Scholar databases yielded 376 studies. Scanning titles and abstracts from studies that met the inclusion and exclusion criteria resulted in 6 articles. In total, there were 973 patients with distal radius fractures who received different treatment on bisphosphonate therapy. There was a significant difference in time to union with bisphosphonates (WMD=0.56; 95% CI=-0.94-2.06). Meanwhile, there was no significant difference in the assessment of DASH and ROM scores (WMD=0.27; 95% CI= -1.01-1.55).

Conclusion Bisphosphonates provide a slower time to union in osteoporotic patients with distal radius fracture.

References

Bae DS, Howard AW. Distal radius fractures: what is the evidence?. J Pediatr Orthop. 2012;32 Suppl 2:S128-S130.

Kates SL, Ackert-Bicknell CL. How do bisphosphonates affect fracture healing?. Injury. 2016;47 Suppl 1(01):S65-S68.

Lin JT, Lane JM. Osteoporosis: a review. Clin Orthop Relat Res. 2004;(425):126-134.

Paolucci T, Saraceni VM, Piccinini G. Management of chronic pain in osteoporosis: challenges and solutions. J Pain Res. 2016;9:177-186.

Uchiyama S, Itsubo T, Nakamura K, Fujinaga Y, Sato N, Imaeda T, et al. Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time. Bone Joint J. 2013 Nov;95-B(11):1544-50.

Gong HS, Song CH, Lee YH, Rhee SH, Lee HJ, Baek GH. Early initiation of bisphosphonate does not affect healing and outcomes of volar plate fixation of osteoporotic distal radial fractures. J Bone Joint Surg Am. 2012;94(19):1729-1736.

Rozental TD, Vazquez MA, Chacko AT, Ayogu N, Bouxsein ML. Comparison of radiographic fracture healing in the distal radius for patients on and off bisphosphonate therapy. J Hand Surg Am. 2009;34(4):595-602.

Seo JB, Kim JP, Kim CK, et al. Influence of Oral and Intravenous Bisphosphonate for the Patients Treated Surgically in Osteoporotic Distal Radius Fracture. Osteoporosis 2013;11(2):89–95.

Koshy N, Pinto D, Sujir P, Joe V, Kamath KG. effect of alendronate on the healing time of distal radial fractures treated conservatively: An observational study. Asian J Pharm Clin Res. 2017;10(1):168-172.

Duckworth AD, McQueen MM, Tuck CE, Tobias JH, Wilkinson JM, Biant LC, et al. Effect of Alendronic Acid on Fracture Healing: A Multicenter Randomized Placebo-Controlled Trial. J Bone Miner Res. 2019;34(6):1025-1032.


No Supplementary Material available for this article.
Article Views      : 31
PDF Downloads : 13