AAOS 2025: Do NSAIDs Impair Fracture Healing?
Do NSAIDs Impair Fracture Healing? A Meta-Analysis of Randomized Control Trials
Nine RCTs with 1,104 patients undergoing fracture fixation were included in this systematic review and meta-analysis comparing NSAID use versus a control. Pooled outcomes of interest included radiographic non-union rates. Patients treated with NSAIDs had a significantly higher risk of non-union (8.9% vs. 3.9%, RR = 2.20, 95% CI 1.21 - 3.63, p = 0.008). Subgroup analysis indicated that even short-term NSAID use (<2 weeks) was associated with increased non-union risk (RR = 1.97, 95% CI 1.10 - 3.53, p = 0.02). Pediatric patients did not exhibit differences in non-union rates (p > 0.99). These findings suggest that NSAIDs may impair fracture healing, warranting further research on optimal dosing and timing to balance pain control and bone healing.
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