We stand by our conclusion

We thank Dr Lam for his comment¹ pertaining to our Tools for Practice article on the effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on fracture healing.² Animal studies can be very useful for hypothesis generation; however, in this case the human and the animal data differ. The references Lam provided pertained to animal studies and the review article primarily also described animal studies.¹ The human studies referenced in the Boursinos et al study³ did not show a deleterious effect of NSAIDs on fracture healing.

Recently, another randomized controlled study comparing an NSAID (ie, ibuprofen) with morphine for children with uncomplicated fractures found that ibuprofen provided equivalent short-term pain relief with fewer adverse events.⁴ We hope that the authors will also report nonunion rates.

Until evidence from randomized controlled studies demonstrate adverse effects of NSAIDs on human fracture healing, we stand by our original conclusion that NSAIDs can be used for short-term pain relief for children and adults with orthopedic injuries or fractures.

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