TY  - JOUR
T1  - The Effect of Nonsteroidal Anti-Inflammatory Drug Administration on Acute Phase Fracture-Healing: A Review
AU  - Kurmis, Andrew P.
AU  - Kurmis, Timothy P.
AU  - O’Brien, Justin X.
AU  - Dalén, Tore
Y1  - 2012/05/02
N1  - 10.2106/JBJS.J.01743
JO  - The Journal of Bone & Joint Surgery
SP  - 815
EP  - 823
VL  - 94
IS  - 9
N2  - Background: 
  The analgesic efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) is well established, and these agents often form an integral part of posttraumatic pain management. However, potentially deleterious effects of resulting prostaglandin suppression on fracture-healing have been suggested.Methods: 
  A systematic literature review involving searches of electronic databases and online sources was performed to identify articles exploring the influence of NSAIDs on fracture-healing.Results: 
  A structured search approach identified 316 papers as potentially relevant to the topic, and these were manually reviewed. The majority described small-scale studies that were retrospective or observational in nature, with limited control of potentially confounding variables, or presented little key information that was not also present in other studies.Conclusions: 
  Although increasing evidence from animal studies suggests that cyclooxygenase-2 (COX-2) inhibition suppresses early fracture-healing, in vivo studies involving human subjects have not provided convincing evidence to substantiate this concern. We found no robust evidence to attest to a significant and appreciable patient detriment resulting from the short-term use of NSAIDs following a fracture. The balance of evidence in the available literature appears to suggest that a short-duration NSAID regimen is a safe and effective supplement to other modes of post-fracture pain control, without a significantly increased risk of sequelae related to disrupted healing.Level of Evidence: 
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
SN  - 0021-9355
M3  - doi: 10.2106/JBJS.J.01743
UR  - http://dx.doi.org/10.2106/JBJS.J.01743
ER  -