Comparison of the rate of delayed/nonunion in fifth metatarsal fractures receiving anti-inflammatory medications

Barnds, Brandon; Heenan, Matt; Ayres, Jack M; Tarakemeh, Armin; Schroeppel, John Paul; Mullen, Scott; Vopat, Bryan G.

doi:10.1186/s40634-021-00435-x

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…В масштабном исследовании B. Barnds и соавт. [32] было проведено сравнение частоты задержки консолидации или несращения при переломе пятой плюсневой кости -одной из наиболее частых травм стопы, возникающей при физических тренировках и нагрузках. Среди 10 991 лица, перенесшего этот перелом за период с 2007 по 2018 г., 13,3% вынуждены были принимать НПВП как минимум в течение 2 месяцев.…”

Section: нпвп и репарация переломов: реальная клиническая практикаunclassified

Nonsteroidal anti-inflammatory drugs for pain relief in case of injuries: Is there a risk of bone metabolism disorders and nonunion of bone fractures?

Karateev¹,

Nikitinskaya²,

Торопцова³

et al. 2022

Naučno-praktičeskaâ revmatologiâ

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According to experimental studies, nonsteroidal anti-inflammatory drugs (NSAIDs) can affect the healing of bone tissue after fractures. The significance of this effect of NSAIDs for real clinical practice is the subject of discussion. We analyzed publications on the problem of nonunion or development of fractures against the background of taking NSAIDs presented in the PubMed and MEDLINE system. From 1976 to 2021, 75 papers on this topic were published, of which 19 were observational, cohort and randomized controlled trials, as well as case-control studies, 4 meta-analyses. According to meta-analyses, which included from 6 to 16 studies, there was an association between taking NSAIDs and nonunion of bones after fractures or postoperative trauma: the odds ratio ranged from 2.07 (95% CI: 1.19–3.61) to 5.27 (95% CI: 2.34–11.88). A number of large studies confirm an increased risk of nonunion of fractures and the development of “marching” fractures in patients treated with NSAIDs. The risk of nonunion was increased when using NSAIDs for more than 2 weeks and in high doses. With short-term use of NSAIDs (less than 2 weeks) and the use of these drugs in pediatric practice, the frequency of bone tissue repair disorders did not increase.

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Section: нпвп и репарация переломов: реальная клиническая практикаunclassified

Nonsteroidal anti-inflammatory drugs for pain relief in case of injuries: Is there a risk of bone metabolism disorders and nonunion of bone fractures?

Karateev¹,

Nikitinskaya²,

Торопцова³

et al. 2022

Naučno-praktičeskaâ revmatologiâ

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“…13 In line with the findings, subjects receiving NSAIDs within 60 days of the first diagnosis in patients, Bandon et al found a statistically significant greater nonunion / delayed union of 5 th MT fractures. 18 Azmi/ JOINTS (Journal Orthopaedi and Traumatology Surabaya) October 2022; 11(2): 70-77…”

Section: Association Between Nsaids/cox-2 Inhibitors and Nonunion Fra...mentioning

confidence: 99%

Do Nsaid/Cox-2 Inhibitors Increase Nonunion After Fracture Surgery? Dilemma and Consideration in Use

Azmi¹

2022

JOINTS

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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.

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“…In patients initially treated conservatively, it was shown that NSAIDs have a negative effect on the healing of the fifth metatarsal fracture. Therefore, NSAIDs are a negative prognostic factor for recovery when treated non-surgically (19).…”

Section: Image 1 Radiographs Of the Right Foot With Fracture Of The F...mentioning

confidence: 99%

Fracture of the Fifth METATARSAL.BIBLIOGRAPHIC Review

García

Pesántez

Gómez

et al. 2022

EPRA

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Introduction: fractures of the fifth metatarsal have various forms of treatment, depending on the type of injury and the person who suffered it. They have great importance and frequency in athletes. They usually occur due to different trauma mechanisms. They were first described in 1902. They are the most prevalent metatarsal fractures and need to be recognized and treated in a timely and appropriate manner. Objective: to detail the current information related to the fifth metatarsal fracture, classification, description, treatment, recovery time as well as the different surgical techniques. Methodology: a total of 29 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 19 bibliographies were used because the other 10 articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: fractura de pie, 5th metatarsal fracture, Jones fracture. Fracture of the fifth metatarsal, fratura do quinto metatarso. Results: the anatomical division system of Lawrence and Bottle is still used. CT and MRI could be considered in the case of delayed healing, stress fracture with normal radiographs or in nonunion. Surgical options include intramedullary screw fixation, bone grafting procedures or a combination of both. Surgical treatment of fractures of the base of the fifth metatarsal in professional athletes offers good clinical results. Conclusions: Regarding the current information related to the fracture of the fifth metatarsal, we note the importance of classification, clinical and social history of the patient, for the appropriate choice of treatment, both conservative and surgical. As for the recovery time in conservative treatment varies depending on the affected area. In delayed union or nonunion, surgical intervention should be performed.

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Comparison of the rate of delayed/nonunion in fifth metatarsal fractures receiving anti-inflammatory medications

Cited by 4 publications

References 22 publications

Nonsteroidal anti-inflammatory drugs for pain relief in case of injuries: Is there a risk of bone metabolism disorders and nonunion of bone fractures?

Nonsteroidal anti-inflammatory drugs for pain relief in case of injuries: Is there a risk of bone metabolism disorders and nonunion of bone fractures?

Do Nsaid/Cox-2 Inhibitors Increase Nonunion After Fracture Surgery? Dilemma and Consideration in Use

Fracture of the Fifth METATARSAL.BIBLIOGRAPHIC Review

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