Hesse Eric, Neuerburg Carl, Kammerlander Christian, Stumpf Ulla, Stange Richard, Böcker Wolfgang
Institut für Molekulare Muskuloskelettale Forschung, Klinikum der Ludwig-Maximilians-Universität München, Fraunhoferstr. 20, 82152, München-Martinsried, Deutschland.
Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland.
Unfallchirurg. 2019 Jul;122(7):506-511. doi: 10.1007/s00113-019-0669-x.
For the treatment of disturbed fracture healing, drugs could be given in addition to surgical procedures. Specific osteoporosis drugs affect the bone metabolism and are used to treat osteoporosis, particularly after a fragility fracture has occurred. Therefore, their use would be conceivable to improve a disturbed fracture healing.
This article presents the available and upcoming specific osteoporosis drugs and investigates whether these substances affect fracture healing in the context of osteoporosis. Furthermore, it is discussed whether disturbed fracture healing can be improved by the use of these substances.
A literature search (PubMed) was conducted using key terms. Preclinical studies, clinical studies, reviews and meta-analyses were considered in order to present the current knowledge in a clinically relevant context.
Preclinical and clinical studies show that specific osteoporosis drugs have no relevant negative impact on the healing of fragility fractures. A tendency to improve a disturbed fracture healing was attributed to bone anabolic substances; however, studies are inconsistent and there is no approval for this application.
Following a fragility fracture, osteoporosis should be diagnosed according to the guidelines and, if necessary, treated with specific osteoporosis drugs, since in principle they do not impair fracture healing but significantly reduce the risk of subsequent fractures. Approval to improve fracture healing requires further investigations.
对于治疗骨折愈合不良，除手术外还可使用药物。特定的骨质疏松症药物会影响骨代谢，用于治疗骨质疏松症，尤其是在发生脆性骨折之后。因此，可以设想使用这些药物来改善骨折愈合不良的情况。
本文介绍了现有的和即将出现的特定骨质疏松症药物，并研究这些物质在骨质疏松症背景下是否会影响骨折愈合。此外，还讨论了使用这些物质是否可以改善骨折愈合不良的情况。
使用关键词进行文献检索（PubMed）。纳入临床前研究、临床研究、综述和荟萃分析，以便在临床相关背景下呈现当前的知识。
临床前和临床研究表明，特定的骨质疏松症药物对脆性骨折的愈合没有相关的负面影响。骨合成代谢物质有改善骨折愈合不良的趋势；然而，研究结果并不一致，且该应用尚未获得批准。
发生脆性骨折后，应根据指南诊断骨质疏松症，必要时使用特定的骨质疏松症药物进行治疗，因为原则上它们不会损害骨折愈合，但会显著降低后续骨折的风险。批准用于改善骨折愈合还需要进一步研究。
