$Illustration of a humerus fracture healing with bisphosphonates.$

Early Bisphosphonates After a Humerus Fracture: A Healing Help or Hindrance?

Avery Sinclair in Health & Wellness December 2025 • 3 min read.

"New research explores whether starting bisphosphonates soon after a broken upper arm affects bone healing in osteoporosis patients. Get the facts!"

Osteoporosis, characterized by weakened bones, significantly elevates fracture risk. Humeral fractures, or breaks in the upper arm, are particularly common among individuals with osteoporosis, ranking among the most frequent fracture types alongside vertebral, hip, and distal forearm fractures.

Bisphosphonates (BPs) are frequently prescribed to combat osteoporosis. These medications slow bone breakdown and can boost bone density, reducing the likelihood of fractures. However, concerns exist about their potential impact on fracture healing since they interfere with the natural bone remodeling process.

A recent study investigated the safety of initiating bisphosphonate treatment shortly after a proximal humerus fracture (near the shoulder) in patients with osteoporosis. The goal was to determine if early bisphosphonate use affects fracture healing and overall outcomes when using a locking compression plate.

Early Bisphosphonate Use: Does It Impact Healing?

Illustration of a humerus fracture healing with bisphosphonates.

The study, published in Clinics in Orthopedic Surgery, retrospectively examined 82 patients with osteoporosis who experienced a proximal humerus fracture and underwent surgical fixation with a locking plate. Researchers divided participants into two groups based on when they started taking alendronate, a common bisphosphonate:

Group A: Initiated bisphosphonate treatment within two weeks after surgery.

Group B: Started bisphosphonate treatment three months after surgery.

The researchers then monitored both groups for radiographic bone union (evidence of healing on X-rays) at various intervals (2, 6, 10, and 16 weeks, 6 months, and 1 year). They also assessed clinical outcomes using the Constant score and the American Shoulder and Elbow Surgeons (ASES) score, both measures of shoulder function, one year after surgery.

The Verdict: Bisphosphonates Don't Hinder Healing

The study revealed no significant differences between the two groups regarding radiographic bone union or clinical outcomes after locking plate fixation. All patients achieved fracture union, with similar average healing times in both groups (6.3 weeks for Group A and 6.6 weeks for Group B).

These findings suggest that initiating bisphosphonate treatment early (within two weeks) following a proximal humerus fracture in patients with osteoporosis does not negatively affect bone healing or clinical outcomes when using a locking compression plate.

While promising, it's important to note this study's limitations, including a relatively small sample size and a need for longer-term follow-up to fully assess potential complications and the long-term effects of early osteoporosis treatment. Nevertheless, the research offers reassuring evidence for clinicians considering early bisphosphonate administration in this patient population.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.4055/cios.2016.8.4.437, Alternate LINK

Title: Influence Of Early Bisphosphonate Administration For Fracture Healing In Patients With Osteoporotic Proximal Humerus Fractures

Subject: Orthopedics and Sports Medicine

Journal: Clinics in Orthopedic Surgery

Publisher: The Korean Orthopaedic Association

Authors: Joong-Bae Seo, Jae-Sung Yoo, Jee-Won Ryu, Kun-Woong Yu

Published: 2016-01-01

Everything You Need To Know

What are bisphosphonates and why are they prescribed for osteoporosis?

Bisphosphonates, like alendronate, are medications used to treat osteoporosis by slowing bone breakdown and increasing bone density. They help to reduce the risk of fractures, which is a major concern for individuals with osteoporosis.

How was the study designed to investigate the impact of early bisphosphonate use after a humerus fracture?

The study in *Clinics in Orthopedic Surgery* focused on patients with osteoporotic proximal humerus fractures treated with locking plate fixation. One group (Group A) started alendronate within two weeks post-surgery, while the other (Group B) began three months after. Researchers tracked radiographic bone union and shoulder function using the Constant score and ASES score.

What did the study find regarding the effect of early bisphosphonate use on bone healing after a proximal humerus fracture?

The study indicated that initiating bisphosphonate treatment, specifically alendronate, early after a proximal humerus fracture does not hinder bone healing. Both groups achieved fracture union with similar healing times, and there were no significant differences in clinical outcomes measured by the Constant score and ASES score at the one-year follow-up.

What is a proximal humerus fracture, and why is it a concern for people with osteoporosis?

A proximal humerus fracture is a break in the upper arm bone near the shoulder, commonly treated with surgical fixation using a locking plate. Osteoporosis increases the risk of such fractures due to weakened bones. Bisphosphonates like alendronate are often prescribed to manage osteoporosis, but their early use post-fracture raises concerns about interfering with natural bone remodeling.

Does this study provide all the answers about bisphosphonates and fracture healing for all situations?

While this study focused on alendronate and its impact on proximal humerus fractures treated with locking plates, it's important to consider that other types of bisphosphonates and fracture locations might yield different results. Further research could explore the effects of various bisphosphonates on different fracture types and in diverse patient populations to provide more comprehensive guidelines for fracture management in osteoporosis.