非甾体类抗炎药对桡骨远端骨折术后愈合率的影响

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-05-21 DOI:10.1016/j.jhsg.2025.03.001

Michael Chang MD , Alexis Kasper BS , Juliet Chung MD , Justin Wright BS , Margaret Pennington MD , Asif M. Ilyas MD, MBA

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引用次数: 0

摘要

目的控制骨折术后疼痛的多模式疼痛方案通常包括非甾体抗炎药（NSAIDs）。然而，一些外科医生仍然不愿意开非甾体抗炎药，因为担心影响骨愈合。本研究假设短期处方非甾体抗炎药治疗桡骨远端骨折修复术后疼痛不会导致愈合率的显著差异。方法回顾性分析在同一学术机构接受掌侧锁定钢板手术修复桡骨远端骨折的5例患者。该队列分为术后处方+NSAIDs组和未处方（-NSAIDs）组。记录患者术前特征和术后疼痛方案。比较两组的主要结局是愈合率和其他次要结局，包括愈合时间和处方阿片类药物的数量。结果纳入最终分析的494例患者中，使用+NSAIDs的患者115例，未使用-NSAIDs的患者379例。术前人口统计和合并症在组间是平衡的。类似比例的患者服用了某种阿片类药物。然而，非甾体抗炎药+组处方的阿片类药物数量较少。总体非工会率为1.2%。在这些病例中，2例在+NSAIDs组，4例在-NSAIDs组。两组结合力无明显差异。结论在本研究中，桡骨远端骨折掌侧锁定钢板固定后处方非甾体抗炎药与骨不愈合率增加无关。该研究可能减轻了非甾体抗炎药在桡骨远端骨折修复术后作为多模式疼痛治疗方案的一部分可能危及骨折愈合的担忧。研究类型/证据水平

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The Effect of Nonsteroidal Anti-Inflammatory Drugs on Union Rates Following Operative Repair of Distal Radius Fractures

Purpose

Multimodal pain regimens for controlling postoperative pain after surgery for fractures often include nonsteroidal anti-inflammatory drugs (NSAIDs). However, some surgeons remain reluctant toward prescribing NSAIDs because of concerns of compromised bone healing. The study hypothesis was that a short-term prescription of NSAIDs for postoperative pain after distal radius fracture repair would not result in a significant difference in union rates.

Methods

Consecutive patients who underwent surgical repair of a distal radius fracture with a volar locking plate from a single academic institution with five hand surgery fellowship-trained orthopedic surgeons were retrospectively reviewed. The cohort was divided into those prescribed +NSAIDs and those who were not (-NSAIDs) postoperatively. Preoperative patient characteristics and postoperative pain regimens were recorded. Comparisons between the two groups were made based on the primary outcome being union rate and other secondary outcomes, including time to union and number of opioid tablets prescribed.

Results

Four hundred and ninety-four patients were included in the final analysis, of which 115 were prescribed +NSAIDs, and 379 were not (-NSAIDs). Preoperative demographics and comorbidities were balanced between groups. A similar proportion of patients were prescribed some type of opioid. However, the +NSAIDs group was prescribed a fewer number of opioid tablets. The overall nonunion rate was 1.2%. Of these cases, two were in the +NSAIDs group, and four were in the -NSAIDs group. There was no difference in union rate between the two groups.

Conclusions

The prescribing of NSAIDs after volar locking plate fixation of distal radius fractures was not associated with an increased nonunion rate in this study. This study may alleviate concerns that NSAIDs might jeopardize fracture healing when used postoperatively as part of a multimodal pain regimen following distal radius fracture repair.