Maus Uwe, Maier Gerrit Steffen, Lazovic Djordje, Niedhart Christopher
Pius-Hospital, Universitätsklinik für Orthopädie und Unfallchirurgie, Carl von Ossietzky Universität, Georgstr. 12, 26121, Oldenburg, Deutschland.
Orthopädische Gemeinschaftspraxis, Liecker Str. 23, 52525, Heinsberg, Deutschland.
Unfallchirurg. 2019 Jul;122(7):500-505. doi: 10.1007/s00113-019-0670-4.
Bone healing after fractures is influenced by many different factors. Besides patient-related factors, such as age, gender and other comorbidities, other drugs taken also have a relevant impact on bone healing.
The aim of the study was to give an overview of the effects of frequently used drugs on fracture healing, with the exception of specific osteoporosis drugs and hormones.
This overview is based on a medline search with the search string of each pharmacological agent.
Frequently used pharmacological substances were identified, for example corticosteroids, antihypertensive drugs, diuretics, antidepressive drugs, antiepileptics, statins, antibiotics, nonsteroidal anti-inflammatory drugs, anticoagulants and others. Except for antihypertensive drugs, thiazide diuretics and statins, which have osteoprotective effects and stimulate bone healing, all other drugs have negative effects on fracture healing in preclinical and animal studies. Clinical data are scarce.
Data for the effects of the abovementioned pharmacological substances could be found mostly in preclinical studies. The effects of these agents on bone healing in humans has currently not been studied or published. Therefore, the use of these drugs should be discussed carefully in cases with a compromised fracture healing.
骨折后的骨愈合受多种不同因素影响。除患者相关因素,如年龄、性别和其他合并症外,所服用的其他药物也对骨愈合有相关影响。
本研究旨在概述常用药物对骨折愈合的影响,但不包括特定的骨质疏松药物和激素。
本综述基于对每种药理剂使用检索词进行的医学文献数据库检索。
确定了常用的药理物质,例如皮质类固醇、抗高血压药物、利尿剂、抗抑郁药物、抗癫痫药物、他汀类药物、抗生素、非甾体抗炎药、抗凝剂等。除具有骨保护作用并能促进骨愈合的抗高血压药物、噻嗪类利尿剂和他汀类药物外,所有其他药物在临床前和动物研究中均对骨折愈合有负面影响。临床数据稀缺。
上述药理物质作用的数据大多可在临床前研究中找到。目前尚未对这些药物对人类骨愈合的作用进行研究或发表。因此,在骨折愈合受损的情况下,应谨慎讨论这些药物的使用。