NSAID exposure may increase nonunion rates of long bone fractures
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Use of NSAIDs increased nonunion rates in patients with operative fixation of humeral shaft, tibial shaft and subtrochanteric femur fractures, according to published results.
Researchers from the department of orthopedic surgery at the University of Kansas Medical Center used ICD and CPT codes to identify and analyze information on 5,310 tibial shaft, 3,947 humeral shaft and 8,432 subtrochanteric femur fractures performed from 2007 to 2016,.
According to the study, patients who avoided postoperative NSAID use had nonunion rates of 11.4% for tibial shaft, 10.1% for humeral shaft and 4.6% for subtrochanteric femur fractures.
NSAID use was documented in 900 tibial shaft, 694 humeral shaft and 967 subtrochanteric femur fracture fixations. Among those patients, nonunion rates were 18.8%, 17.4% and 10.4%, respectively – a nonunion risk 2.4 times higher in subtrochanteric femur fractures and 1.7 times higher in both tibial shaft and humeral shaft fractures, according to the study.
“In the subanalysis of cost, the data demonstrated that cost was substantially increased for all nonunion management, as expected and in accordance with prior studies,” the researchers wrote in the study. “In the current health care environment and with the goal of minimizing opiate analgesia during fracture management, NSAIDs play a key role in the control of patients’ pain. However, these medications must not be used at the expense of fracture healing,” they concluded.
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