Ijaz Ahmad, Ashfaq Ahmed, Muhammad Imran Javed, Ahsan Atta, Ammar Dogar, Rizwan Akram, Amer Aziz.
Role of strontium ranelate in healing of surgically fixed long bone fractures after delayed/non-union: a double blind randomized controlled trial.
Pak J Surg Jan ;36(4):333-8.

Objective: Delayed union, mal-union, non-union and bone loss after long bone fractures have remained a significant predicament in orthopedic practice. To enhance bone union after surgical fixation drugs such as strontium ranelate have shown a promising role. This study aims to assess the effect of strontium ranelate in closed diaphyseal long bone fractures that were managed with intra-medullary nailing and have undergone delayed/non-union. Material and Methods: A randomized clinical trial was conducted at the Department of Orthopedics and Spine Centre, Ghurki Trust Teaching Hospital, Lahore from December 2016 to January 2018. Patients with non-union of long bone fractures were included after taking informed consent. They were randomized to receive placebo or strontium ranelate aft er nonunion of closed diaphyseal fractures of long bones that were managed with intra-medullary nailing. Fractures were assessed clinically in form of Pain reduction as well as general feeling of wellbeing and radiologically at day 7, 14, 30, 60 and 90. SPSS Version 23 was used for statistical analysis. Results: Of the 101 patients, 50 were randomly assigned to treatment group and 51 were randomly assigned to placebo group. Clinically enhanced fracture healing efficacy of treatment group was 86% (n=43) and radiologically it was 84% (n=42). Clinically enhanced fracture healing efficacy of placebo group was 60.8% (n=31) and radiologically it was 68.6% (n=35). General feeling of wellbeing significantly improved after treatment with strontium ranelate. Conclusion: Systemic strontium ranelate has an exciting and promising role in management of fractures that have undergone non-union/delayed union in non-osteoporotic long bones and should always be considered in such patients.

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