Use of nonsteroidal anti-inflammatory drugs and risk of delayed bone healing following elective foot surgery

Abstract

Purpose: Determine if short-term exposure to nonsteroidal anti-inflammatory drugs (NSAIDs) peri‑operatively results in increased risk of delayed bone healing in elective forefoot surgery. Methodology & Procedure: 35 patients without contraindication to receiving NSAIDs underwent elective osseous forefoot surgery between 7/1/2018 – 5/30/2019 and received intra-operative IV ketorolac and/or post-operative PO ibuprofen in addition to regularly prescribed pain medications. Patients were followed post-operatively and monitored for clinical signs of delayed bone healing. This prospective group was compared to a retrospective group of 48 patients who underwent elective osseous forefoot surgery between 1/1/2017 – 6/30/2018 and had no exposure to NSAIDs in the peri‑operative period. Statistical analysis was performed utilizing Fisher's exact test and t-test to calculate p values where <0.05 was statistically significant. Results: There were 3 cases of delayed union in the prospective group (n = 35) and 3 cases in the retrospective group (n = 48). Analysis and Discussion: Literature has shown that use of peri‑operative NSAIDs can help manage surgical pain. Surgeons have been hesitant to utilize NSAIDs in the peri‑operative period due to concern for delayed bone healing. In our study, there was no statistically significant difference in bone healing between the two groups. Incorporating NSAIDs peri‑operatively could decrease use of narcotics without increased risk of delayed bone healing.

Keywords

• Arthrodesis
• foot
• non-union
• NSAID
• osteotomy