BACKGROUND Non-steroidal anti-inflammatory drugs(NSAIDs)are among the most commonly prescribed medications in the United States.Although they are safe and effective means of analgesia for children with broken bones,th...BACKGROUND Non-steroidal anti-inflammatory drugs(NSAIDs)are among the most commonly prescribed medications in the United States.Although they are safe and effective means of analgesia for children with broken bones,there is considerable variation in their clinical use due to persistent concerns about their potentially adverse effect on fracture healing.AIM To assess whether NSAID exposure is a risk factor for fracture nonunion in children.METHODS We systematically reviewed the literature reporting the effect of NSAIDs on bone healing.We included all clinical studies that reported on adverse bone healing complications in children with respect to NSAID exposure.The outcomes of interest were delayed union or nonunion.Study quality was assessed using the Newcastle-Ottawa scale for non-randomized studies.A final table was constructed summarizing the available evidence.RESULTS A total of 120 articles were identified and screened,of which 6 articles were included for final review.Nonunion in children is extremely rare;among the studies included,there were 2011 nonunions among 238822 fractures(0.84%).None of the included studies documented an increased risk of nonunion or delayed bone healing in those children who are treated with NSAIDs in the immediate post-injury or peri-operative time period.Additionally,children are likely to take these medications for only a few days after injury or surgery,further decreasing their risk of adverse side-effects.CONCLUSION This systematic review suggests that NSAIDS can be safely prescribed to pediatric orthopaedic patients absent other contraindications without concern for increased risk of fracture non-union or delayed bone healing.Additional prospective studies are needed focusing on higher risk fractures and elective orthopaedic procedures such as osteotomies and spinal fusion.展开更多
This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse ...This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse effects.With hand fractures being significantly common and postoperative pain management crucial for recovery,the potential of NSAIDs offers a non-addictive pain control alternative.However,the controversy over NSAIDs'effects on bone healing—stemming from their Cyclooxygenase-2 inhibition and associated risks of fracture non-union or delayed union—necessitates further investigation.Despite a comprehensive literature search,the study finds a lack of specific research on NSAIDs in postoperative hand fracture management,highlighting an urgent need for future studies to balance their benefits against possible risks.展开更多
目的探究益肾补骨汤联合常规西药对绝经后脊柱压缩性骨折患者术后愈合效果和腰椎功能的影响。方法将该院2021年5月—2022年5月收治的110例绝经后脊柱压缩性骨折患者依据入院建档单双号分为对照组(55例)及观察组(55例)。对照组予以常规...目的探究益肾补骨汤联合常规西药对绝经后脊柱压缩性骨折患者术后愈合效果和腰椎功能的影响。方法将该院2021年5月—2022年5月收治的110例绝经后脊柱压缩性骨折患者依据入院建档单双号分为对照组(55例)及观察组(55例)。对照组予以常规西药治疗,观察组在此基础上联合益肾补骨汤治疗,两组均连续治疗1个疗程后观察效果。治疗前后采用视觉模拟评分法(visual analog scale,VAS)量表及数字评分(numerical rating scale,NRS)量表评价两组疼痛情况,采用日本骨科协会腰痛评价表(Japanese Orthopaedic Association Low Back Pain Assessment,JOA)及Oswestry功能障碍指数(Oswestry disability index,ODI)评价两组的腰椎功能变化;比较两组治疗前后的骨代谢水平,并评价两组的术后愈合效果及并发症情况。结果治疗后两组VAS、NRS评分均较降低,且观察组低于对照组(P<0.05);治疗后两组JOA评分升高,ODI评分降低,且观察组JOA评分高于对照组,ODI评分低于对照组(P<0.05);治疗后,两组血清总Ⅰ型胶原氨基端延长肽(total type I collagen amino-terminal elongation peptide,T-PINP)、N-骨钙素(N-terminal osteocalcin,N-MID)水平变化不明显,β-Ⅰ型胶原交联C端肽(type I collagen cross-linked C-terminal peptide,β-CTX)水平低于治疗前,且观察组β-CTX水平显著低于对照组(P<0.05);术后观察组的骨折愈合效果明显优于对照组(P<0.05);两组术后并发症比较差异无统计学意义(P>0.05)。结论益肾补骨汤联合常规西药对绝经后脊柱压缩性骨折患者效果显著,能有效缓解患者的术后疼痛,改善患者腰椎功能,降低骨代谢水平,促进骨折愈合,且无明显的并发症,安全性高。展开更多
文摘BACKGROUND Non-steroidal anti-inflammatory drugs(NSAIDs)are among the most commonly prescribed medications in the United States.Although they are safe and effective means of analgesia for children with broken bones,there is considerable variation in their clinical use due to persistent concerns about their potentially adverse effect on fracture healing.AIM To assess whether NSAID exposure is a risk factor for fracture nonunion in children.METHODS We systematically reviewed the literature reporting the effect of NSAIDs on bone healing.We included all clinical studies that reported on adverse bone healing complications in children with respect to NSAID exposure.The outcomes of interest were delayed union or nonunion.Study quality was assessed using the Newcastle-Ottawa scale for non-randomized studies.A final table was constructed summarizing the available evidence.RESULTS A total of 120 articles were identified and screened,of which 6 articles were included for final review.Nonunion in children is extremely rare;among the studies included,there were 2011 nonunions among 238822 fractures(0.84%).None of the included studies documented an increased risk of nonunion or delayed bone healing in those children who are treated with NSAIDs in the immediate post-injury or peri-operative time period.Additionally,children are likely to take these medications for only a few days after injury or surgery,further decreasing their risk of adverse side-effects.CONCLUSION This systematic review suggests that NSAIDS can be safely prescribed to pediatric orthopaedic patients absent other contraindications without concern for increased risk of fracture non-union or delayed bone healing.Additional prospective studies are needed focusing on higher risk fractures and elective orthopaedic procedures such as osteotomies and spinal fusion.
文摘This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse effects.With hand fractures being significantly common and postoperative pain management crucial for recovery,the potential of NSAIDs offers a non-addictive pain control alternative.However,the controversy over NSAIDs'effects on bone healing—stemming from their Cyclooxygenase-2 inhibition and associated risks of fracture non-union or delayed union—necessitates further investigation.Despite a comprehensive literature search,the study finds a lack of specific research on NSAIDs in postoperative hand fracture management,highlighting an urgent need for future studies to balance their benefits against possible risks.
文摘目的探究益肾补骨汤联合常规西药对绝经后脊柱压缩性骨折患者术后愈合效果和腰椎功能的影响。方法将该院2021年5月—2022年5月收治的110例绝经后脊柱压缩性骨折患者依据入院建档单双号分为对照组(55例)及观察组(55例)。对照组予以常规西药治疗,观察组在此基础上联合益肾补骨汤治疗,两组均连续治疗1个疗程后观察效果。治疗前后采用视觉模拟评分法(visual analog scale,VAS)量表及数字评分(numerical rating scale,NRS)量表评价两组疼痛情况,采用日本骨科协会腰痛评价表(Japanese Orthopaedic Association Low Back Pain Assessment,JOA)及Oswestry功能障碍指数(Oswestry disability index,ODI)评价两组的腰椎功能变化;比较两组治疗前后的骨代谢水平,并评价两组的术后愈合效果及并发症情况。结果治疗后两组VAS、NRS评分均较降低,且观察组低于对照组(P<0.05);治疗后两组JOA评分升高,ODI评分降低,且观察组JOA评分高于对照组,ODI评分低于对照组(P<0.05);治疗后,两组血清总Ⅰ型胶原氨基端延长肽(total type I collagen amino-terminal elongation peptide,T-PINP)、N-骨钙素(N-terminal osteocalcin,N-MID)水平变化不明显,β-Ⅰ型胶原交联C端肽(type I collagen cross-linked C-terminal peptide,β-CTX)水平低于治疗前,且观察组β-CTX水平显著低于对照组(P<0.05);术后观察组的骨折愈合效果明显优于对照组(P<0.05);两组术后并发症比较差异无统计学意义(P>0.05)。结论益肾补骨汤联合常规西药对绝经后脊柱压缩性骨折患者效果显著,能有效缓解患者的术后疼痛,改善患者腰椎功能,降低骨代谢水平,促进骨折愈合,且无明显的并发症,安全性高。
