The Effect of Nonsteroidal Anti-Inflammatory Drug Administration on Acute Phase Fracture-Healing: A Review

Kurmis, Andrew P.; Kurmis, Timothy P.; O’Brien, J; Dalén, Tore

doi:10.2106/jbjs.j.01743

Cited by 97 publications

(50 citation statements)

References 62 publications

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“…One sheep developed a painful hoof infection of a foreleg, unrelated to the experimental procedure. This infection prevented weight-bearing and required intensive treatment with nonsteroidal anti-inflammatory drugs known to suppress fracture-healing 31 . This sheep was replaced to retain the original sample size.…”

Section: Discussionmentioning

confidence: 99%

Dynamic Stabilization with Active Locking Plates Delivers Faster, Stronger, and More Symmetric Fracture-Healing

Bottlang

Tsai

Bliven

et al. 2016

The Journal of Bone and Joint Surgery

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Background: Axial dynamization of fractures can promote healing, and overly stiff fixation can suppress healing. A novel technology, termed active plating, provides controlled axial dynamization by the elastic suspension of locking holes within the plate. This prospective, controlled animal study evaluated the effect of active plates on fracture-healing in an established ovine osteotomy model. We hypothesized that symmetric axial dynamization with active plates stimulates circumferential callus and delivers faster and stronger healing relative to standard locking plates. Methods: Twelve sheep were randomly assigned to receive a standard locking plate or an active locking plate for stabilization of a 3-mm tibial osteotomy gap. The only difference between plates was that locking holes of active plates were elastically suspended, allowing up to 1.5 mm of axial motion at the fracture. Fracture-healing was analyzed weekly on radiographs. After sacrifice at nine weeks postoperatively, callus volume and distribution were assessed by computed tomography. Finally, to determine their strength, healed tibiae and contralateral tibiae were tested in torsion until failure. Results: At each follow-up, the active locking plate group had more callus (p < 0.001) than the standard locking plate group. At postoperative week 6, all active locking plate group specimens had bridging callus at the three visible cortices. In standard locking plate group specimens, only 50% of these cortices had bridged. Computed tomography demonstrated that all active locking plate group specimens and one of the six standard locking plate group specimens had developed circumferential callus. Torsion tests after plate removal demonstrated that active locking plate group specimens recovered 81% of their native strength and were 399% stronger than standard locking plate group specimens (p < 0.001), which had recovered only 17% of their native strength. All active locking plate group specimens failed by spiral fracture outside the callus zone, but standard locking plate group specimens fractured through the osteotomy gap. Conclusions: Symmetric axial dynamization with active locking plates stimulates circumferential callus and yields faster and stronger healing than standard locking plates. Clinical Relevance: The stimulatory effect of controlled motion on fracture-healing by active locking plates has the potential to reduce healing complications and to shorten the time to return to function.

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Section: Discussionmentioning

confidence: 99%

Dynamic Stabilization with Active Locking Plates Delivers Faster, Stronger, and More Symmetric Fracture-Healing

Bottlang

Tsai

Bliven

et al. 2016

The Journal of Bone and Joint Surgery

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“…Our study results on this topic were evenly split regarding perioperative use. There is some concern in the immediate postoperative period that NSAIDs may decrease the amount of inflammation in the shoulder, which may be detrimental to healing 8,9 . Although this has been shown in animal models, there is no evidence that NSAIDs affect healing in humans.…”

Section: Discussionmentioning

confidence: 99%

A Survey of Expert Opinion Regarding Rotator Cuff Repair

Acevedo

Paxton

Williams

et al. 2014

The Journal of Bone and Joint Surgery

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“…Therefore, higher quality studies are needed to assess this issue. 84 The 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults 85 is a useful tool for selecting drugs for use with elderly patients.…”

Section: Postoperative Care: Pain Managementmentioning

confidence: 99%

Hip Fracture in the Elderly

Urrutia¹,

Zamora²,

Klaber³

2017

CMGer

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Hip fractures in elderly patients are the most severe form of fragility fractures. They can lead to significant morbidity and mortality; additionally, they have an enormous economic and social burden. Treatment of hip fractures in elderly patients should be based on a prompt initial evaluation, followed by surgical treatment without unnecessary delays under a collaborative effort of a multidisciplinary team. Postoperative care should be started immediately after surgery, and it must include an intensive rehabilitation, as well as treatment of osteoporosis and any other metabolic imbalance. This review incorporates current literature on initial evaluation and definitive management of hip fractures in the elderly and is intended to assist practitioners of different specialties treating these patients.

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The Effect of Nonsteroidal Anti-Inflammatory Drug Administration on Acute Phase Fracture-Healing: A Review

Cited by 97 publications

References 62 publications

Dynamic Stabilization with Active Locking Plates Delivers Faster, Stronger, and More Symmetric Fracture-Healing

Dynamic Stabilization with Active Locking Plates Delivers Faster, Stronger, and More Symmetric Fracture-Healing

A Survey of Expert Opinion Regarding Rotator Cuff Repair

Hip Fracture in the Elderly

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