DO NSAID/COX-2 INHIBITORS INCREASE NONUNION AFTER FRACTURE SURGERY? DILEMMA AND CONSIDERATION IN USE
| Autor: | Azmi Azmi |
|---|---|
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | (JOINTS) Journal Orthopaedi and Traumatology Surabaya. 11:70-77 |
| ISSN: | 2460-8742 2722-712X |
| DOI: | 10.20473/joints.v11i2.2022.70-77 |
| Popis: | Background: Nonunion accounts for 2 to 10% of fracture complications. It diminishes the quality of life and increases the risk of mortality. Several circumstances, including smoking, metabolic disorders, dietary inadequacy, and nonsteroidal anti-inflammatory drugs (NSAIDs), may predict the development of nonunion. In order to treat postoperative pain, NSAIDs are frequently used, including orthopedic conditions, particularly in the pain management of fracture. Using NSAIDs/cyclooxygenase (COX)-2 inhibitors has been controversial for many years. Many orthopedic surgeons avoid using them in fracture surgery due to the potential harmful effect on osteogenesis and subsequent nonunion risk. Literature Review: We conducted an updated review of the literature using digital databases such as PubMed, Cochrane, Ovid-SP, Springer Link, and Science Direct, including “NSAIDs” OR “COX-2 Inhibitor” AND “nonunion” AND “fracture surgery”. In total 7 publications that met our inclusion criteria were summarized. This literature review revealed that some studies have proved that NSAIDs/COX-2 inhibitors are capable of inhibiting the fracture union temporarily; however, other studies have shown the safety of NSAIDs following fracture fixation without remarkable interference on bone healing. The association of COX-2 inhibitors or non-selective NSAIDs with nonunion remains unclear. Conclusion: Prolonged use of NSAIDs interferes with the response to a successful bone healing. Short-duration (< 2 weeks of treatment) and low-dose use of NSAIDs are considered safe and efficacious for fracture postoperative pain. |
| Databáze: | OpenAIRE |
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