Pharmacological agents and impairment of fracture healing: what is the evidence?

Bone healing is an extremely complex process which depends on the coordinated action of several cell lineages on a cascade of biological events, and has always been a major medical concern. The use of several drugs such as corticosteroids, chemotherapeutic agents, non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, anticoagulants and drugs which reduce osteoclastic activity have been shown to affect bone healing. This review article presents our current understanding on this topic, focusing on data illustrating the effect of these drugs on fracture healing and bone regeneration.