Does ibuprofen inhibit healing after a fracture?

Breaking a bone is a painful experience and the opioid epidemic has left fewer long-term pain relief options. A report takes a look at whether nonsteroidal anti-inflammatory drugs such as ibuprofen hinder bone healing.¹

Investigators performed a prospective, randomized, parallel, single-blinded study that included skeletally immature children who had long bone fractures. The children were randomized into either a group that was treated with weight-based ibuprofen, the intervention group, or treated with weight-based acetaminophen, the control group. Children in both groups were permitted oxycodone for breakthrough pain.

There were 192 children enrolled in the study and 95 patients with 97 fractures completed the 6-month follow-up. There were 46 children with 47 fractures in the control group and 49 patients with 50 fractures in the group treated with ibuprofen. No patient achieved healing at 1 to 2 weeks. By 6 weeks after the fracture, 37 of the 45 children in the control group and 46 of the 50 children in the ibuprofen group had healed fractures. At 10 to 12 weeks, 46 of the children in the control group had healed fractures and all of the children in the ibuprofen group had healed fractures. Every child’s fracture was healed by 6 months. In the control group, health was achieved at an average of 40 days in the control group and 31 days in the ibuprofen group. Oxycodone was used for breakthrough pain for 2.4 days in the control group and 1.9 days for the ibuprofen group.

The investigators concluded that ibuprofen effectively manages pain due to fracture in children. Additionally, using ibuprofen doesn’t impair fracture healing.

Reference

1. Nuelle JA, Coe KM, Oliver HA, Cook JL, Hoernschemeyer DG, Gupta SK. Effect of NSAID use on bone healing in pediatric fractures. Journal of Pediatric Orthopaedics. July 22, 2020. Epub ahead of print. doi:10.1097/bpo.0000000000001603