Patients with primary fragility fractures have a 20%–25% chance of a subsequent fracture within a year of the initial injury [1]. Secondary fractures may result in loss of independence, loss of mobility, and increased mortality [2]. Therefore, patients with hip or vertebral fractures should be the primary target of preventive measures immediately after their first fracture [3]. Anti-resorptive drugs are the most frequently prescribed treatment for fracture prevention; however, these drugs can severely suppress bone metabolism, and there is concern that they may have some adverse effects on the bone healing process after fracture.

Regarding the effect of osteoporosis medications on hip fractures, Jalan et al. [4] reported that early intravenous zoledronic acid administration after intertrochanteric femoral fracture surgery did not delay fracture healing, and Haung et al. [5] reported significantly earlier fracture healing in the teriparatide group compared with the placebo group.

Cummings et al. [6] reported that denosumab reduced the risk of vertebral and nonvertebral fractures compared with placebo in a randomized trial(Fracture Reduction Evaluation of Denosumab in Osteoporosis Every 6 Months (FREEDOM)), and Adami et al. [7] reported that denosumab did not delay fracture healing of nonvertebral fractures. However, there are few clinical reports on the effect of denosumab administration on bone healing of hip fractures.

This prospective study aimed to evaluate the feasibility of early denosumab administration after femoral intertrochanteric fracture surgery by comparing its effect on fracture healing with that of bisphosphonate-treated patients by assessing bone healing by plain radiographs and computed tomography (CT).