Tibia fractures and NSAIDs. Does it make a difference? A multicenter retrospective study

Fader, Lauren; Whitaker, John; Lopez, M. Fernandez-Barriales; Vivace, Bradley J.; Parra, Mauricio; Carlson, Jon; Zamora, Rodolfo

doi:10.1016/j.injury.2018.09.024

Cited by 28 publications

(25 citation statements)

References 23 publications

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“…A randomized controlled trial (RCT) in patients with Colles’ fracture ( n = 95) showed no difference in outcome between the groups receiving ibuprofen and placebo [ 21 ]. In another more recent multicenter observational study, NSAID use versus opioid use after intermedullary nailing of diaphyseal tibia fractures ( n = 372) had no effect on healing time [ 22 ]. The lack of an effect in pediatric patients has also been confirmed in an RCT of NSAID (ibuprofen) versus no NSAID ( n = 102) after long bone fractures; there were no differences in time to clinical or radiographic healing [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

Do NSAIDs Really Interfere with Healing after Surgery?

Schug

2021

JCM

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Perioperative analgesia should be multimodal to improve pain relief, reduce opioid use and thereby adverse effects impairing recovery. Non-steroidal anti-inflammatory drugs (NSAIDs) are an important non-opioid component of this approach. However, besides potential other adverse effects, there has been a longstanding discussion on the potentially harmful effects of NSAIDs on healing after surgery and trauma. This review describes current knowledge of the effects of NSAIDs on healing of bones, cartilage, soft tissue, wounds, flaps and enteral anastomoses. Overall, animal data suggest some potentially harmful effects, but are contradictory in most areas studied. Human data are limited and of poor quality; in particular, there are only very few good randomized controlled trials (RCTs), but many cohort studies with potential for significant confounding factors influencing the results. The limited human data available are not precluding the use of NSAIDs postoperatively, in particular, short-term for less than 2 weeks. However, well-designed and large RCTs are required to permit definitive answers.

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Section: Resultsmentioning

confidence: 99%

Do NSAIDs Really Interfere with Healing after Surgery?

Schug

2021

JCM

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“…Some doctors believe that intramedullary nailing (IMN) is the gold standard for the treatment of tibial fractures [ 23 , 24 ]; however, most doctors consider that different treatment options have different advantages [ 25 – 28 ]. The use of non-steroidal anti-inflammatory drugs (NSAIDs) and the fixation of fibular fractures have also been considered as controversial factors for many years [ 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and influencing factors of nonunion in patients with tibial fracture: systematic review and meta-analysis

et al. 2020

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Objective The aim of this study is to assess the prevalence of nonunion in patients with tibia fracture and the association between influencing factors and tibia fracture nonunion. Method A database searches of PubMed, the Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Weipu database, and Wanfang database from inception until June 2019 was conducted. The pooled prevalence, odds ratio (OR), and 95% confidence intervals (CI) were calculated with Stata software. Results In this study, 111 studies involving 41,429 subjects were included. In the study of the relationship between influencing factors and tibia fracture nonunion, 15 factors significantly influenced the fracture union, including > 60 years old, male, tobacco smoker, body mass index > 40, diabetes, nonsteroidal anti-inflammatory drugs (NSAIDs) user, opioids user, fracture of middle and distal tibia, high-energy fracture, open fracture, Gustilo-Anderson grade IIIB or IIIC, Müller AO Classification of Fractures C, open reduction, fixation model, and infection. Conclusion The prevalence of nonunion in patients with tibia fracture was 0.068 and 15 potential factors were associated with the prevalence. Closed reduction and minimally invasive percutaneous plate osteosynthesis (MIPPO) have the low risks of nonunion for the treatment of tibial fractures.

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“…54 However, the effect was not identified for low-dose NSAIDs (diclofenac <125 mg/ day, ketorolac 120 mg/day) taken for less than 2 weeks, which has been confirmed in additional studies. [55][56][57] Nonetheless, spine surgeons have erred on the side of caution and prefer to avoid NSAIDs postoperatively. 58 Additionally, within patients undergoing colorectal surgery, a meta-analysis (24 studies, n = 31,877) showed an increased risk for anastomotic leaks (OR 1.73, 95% CI 1.31 to 2.29) with the use of NSAIDs.…”

Section: Nonsteroidal Anti-inflammatory Drugs (Nsaids)mentioning

confidence: 99%

Postoperative Pain Management

Mazda

Jadin

Kahn

2021

Can Journ Gen Int Med

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After surgery, over 80% of people experience moderate-to-severe acute pain. Poorly controlled postoperative pain limits recovery and is associated with detrimental short- and long-term morbidity. While surgeons have traditionally been responsible for postoperative pain management, all clinicians providing care for surgical patients have a basic understanding of common pharmacologic and interventional pain management strategies. In this review, we discuss the consequences of acute pain, approaches to pain assessment, and an overview of commonly used therapies to manage postoperative pain. RÉSUMÉAprès une opération, plus de 80 % des gens ressentent des douleurs aiguës modérées à intenses. Une douleur postopératoire mal maîtrisée limite le rétablissement et est associée à une morbidité défavorable à court et à long terme. Bien que les chirurgiens soient habituellement responsables du traitement de la douleur postopératoire, il est impératif que tous les cliniciens qui soignent des patients ayant subi une intervention chirurgicale aient une connaissance de base des stratégies pharmacologiques et interventionnelles courantes relatives au traitement de la douleur. Dans cette revue, nous abordons les conséquences de la douleur aiguë, les approches de l’évaluation de la douleur et un aperçu des traitements couramment utilisés pour traiter la douleur postopératoire.

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Tibia fractures and NSAIDs. Does it make a difference? A multicenter retrospective study

Cited by 28 publications

References 23 publications

Do NSAIDs Really Interfere with Healing after Surgery?

Do NSAIDs Really Interfere with Healing after Surgery?

Prevalence and influencing factors of nonunion in patients with tibial fracture: systematic review and meta-analysis

Postoperative Pain Management

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