To evaluate the effects of commonly prescribed medications on fracture healing in adult patients.
Key Findings:
Most evidence focused on fracture incidence or bone health rather than direct fracture healing outcomes.
Nonsteroidal anti-inflammatory drugs showed limited effects on healing with short-term use but associations with delayed union or nonunion with prolonged exposure.
Systemic corticosteroids reduced bone formation but lacked direct evidence on fracture healing outcomes.
Vitamin K antagonists increased fracture risk, while direct oral anticoagulants showed lower fracture rates.
Selective serotonin reuptake inhibitors were linked to increased fracture risk, but evidence on healing outcomes was limited.
Metabolic diseases like diabetes were associated with delayed healing and higher complication rates.
Interpretation:
Medication effects on fracture healing are variable and depend on timing, duration, and patient characteristics, necessitating careful clinical consideration.
Limitations:
Narrative design lacked quantitative pooling and formal risk-of-bias assessment.
Heterogeneity in study design and outcome measures limited comparability.
Evidence for many medication classes was indirect, focusing on fracture risk rather than healing-specific outcomes, and observational findings were subject to confounding by indication and comorbidity burden.
Conclusion:
The effects of medications on fracture healing are complex and should be interpreted in the context of individual patient factors and medication exposure.
