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LetterCorrespondance

Fracture healing and NSAIDs

Christopher Lam
Canadian Family Physician November 2014, 60 (11) 985;
Christopher Lam
Vancouver, BC
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The article by Taylor et al provided very limited data comparing use of analgesics and rates of nonunion.1 It is pretty drastic to conclude that “patients should not be denied NSAIDs [nonsteroidal anti-inflammatory drugs] for short-term pain relief.”1 In terms of fracture healing there is evidence in rodent studies that NSAIDs can slow healing.2–4 A review article by Boursinos et al advised caution in using NSAIDs in patients with fractures.5 As inflammation is the first step in the healing process, and given the range of choice of analgesics, there is no particular reason to recommend NSAIDs after a fracture.

Footnotes

  • Competing interests

    None declared

  • Copyright© the College of Family Physicians of Canada

References

  1. 1.↵
    1. Taylor IC,
    2. Lindblad AJ,
    3. Kolber MR
    . Fracture healing and NSAIDs. Can Fam Physician 2014;60:817. (Eng), e429 (Fr).
    OpenUrlFREE Full Text
  2. 2.↵
    1. Li J,
    2. Waugh LJ,
    3. Hui SL,
    4. Burr DB,
    5. Warden SJ
    . Low-intensity pulsed ultrasound and nonsteroidal anti-inflammatory drugs have opposing effects during stress fracture repair. J Ortho Res 2007;25(12):1559-67.
    OpenUrlPubMed
  3. 3.
    1. Murnaghan M,
    2. Li G,
    3. Marsh DR
    . Nonsteroidal anti-inflammatory drug-induced fracture nonunion: an inhibition of angiogenesis? J Bone Joint Surg Am 2006;88(Suppl 3):140-7.
    OpenUrlAbstract/FREE Full Text
  4. 4.↵
    1. Brown KM,
    2. Saunders MM,
    3. Kirsch T,
    4. Donahue HJ,
    5. Reid JS
    . Effect of COX-2-specific inhibition on fracture-healing in the rat femur. J Bone Joint Surg Am 2004;86-A(1):116-23.
    OpenUrlAbstract/FREE Full Text
  5. 5.↵
    1. Boursinos LA,
    2. Karachalios T,
    3. Poultsides L,
    4. Malizos KN
    . Do steroids, conventional nonsteroidal anti-inflammatory drugs and selective Cox-2 inhibitors adversely affect fracture healing? J Musculoskelet Neuronal Interact 2009;9(1):44-52.
    OpenUrlPubMed
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Canadian Family Physician: 60 (11)
Canadian Family Physician
Vol. 60, Issue 11
1 Nov 2014
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Fracture healing and NSAIDs
Christopher Lam
Canadian Family Physician Nov 2014, 60 (11) 985;

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