This article is more than 5 years old. Information may no longer be current.
Extended indomethacin treatment increased nonunion incidence after acetabular fracture surgery
Six-week indomethacin treatment had no therapeutic effect for decreasing heterotopic ossification after acetabular fracture surgery and appeared to increase incidence of nonunion, according to study results.
In a prospective, double-blind study, researchers randomly assigned 98 patients with an acute acetabular fracture requiring operative treatment to receive placebo for 6 weeks (group one) or treatment with indomethacin for 3 days (group two), 1 week (group three) or 6 weeks (group four). Main outcome measures included the overall incidence, Brooker class and volume of heterotopic ossification (HO); radiographic union of acetabular fracture and pain.
The researchers performed clinical and radiographic follow-up at 6 weeks, 3 months, 6 months and 1 year. At 6 months, computed tomography scans were used to assess healing and HO volume.
Among the 68 patients who completed follow-up and had 6-month CT scan results, the researchers found an overall HO incidence of 67% for groups one and four, and 29% for groups two and three.
For group one, volume of HO formation was 17,900 mm3 and there was an incidence of radiographic nonunion of 19%; group two had a HO formation volume of 33,800 mm3 and an incidence of radiographic nonunion of 35%; group three had a HO formation volume of 6,300 mm3 and an incidence of radiographic nonunion of 24%; and group four had an HO formation volume of 11,100 mm3 and an incidence of radiographic nonunion of 62%.
The researchers found 77% of nonunion incidence involved the posterior wall segment. VAS pain scores were significantly higher for patients with radiographic nonunion.
Disclosure: The authors have no relevant financial disclosures.