BoneKEy Reports | BoneKEy Watch

NSAIDs do not appear to delay fracture healing

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DOI:10.1038/bonekey.2012.128

Whether the use of non-steroidal anti-inflammatory drugs (NSAIDs) as analgesics after a traumatic fracture actually impedes fracture healing has been debated since the 1970s. The current review identified 316 studies describing the impact of NSAIDs on fractures; many were retrospective or small-scale studies that were judged to be of limited use, but 83 articles were chosen for inclusion.

Some early animal studies suggested that COX-2 inhibition by NSAIDs suppressed fracture healing, but human studies have not shown evidence of this effect. The clinical evidence reviewed shows that patients with simple fractures benefit from the pain-killing effects of NSAIDs without any apparent detriment to osseous repair. Neither did they find any support for the view that patients judged to be at high risk of poor fracture healing should be declined NSAIDs, although they agree that this may still be good practice.

Editor's comment:

This is a timely review, which includes human outcomes. Despite animal studies that raised initial concerns, short-term regimens of COX-2 inhibitors may not appreciably inhibit bone repair, and have advantages over other forms of analgesia.

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