Department of Orthopaedics, Repatriation General Hospital, Daws Road, Daw Park 5041, South Australia, Australia.
J Bone Joint Surg Am. 2012 May 2;94(9):815-23. doi: 10.2106/JBJS.J.01743.
The analgesic efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) is well established, and these agents often form an integral part of posttraumatic pain management. However, potentially deleterious effects of resulting prostaglandin suppression on fracture-healing have been suggested.
A systematic literature review involving searches of electronic databases and online sources was performed to identify articles exploring the influence of NSAIDs on fracture-healing.
A structured search approach identified 316 papers as potentially relevant to the topic, and these were manually reviewed. The majority described small-scale studies that were retrospective or observational in nature, with limited control of potentially confounding variables, or presented little key information that was not also present in other studies.
Although increasing evidence from animal studies suggests that cyclooxygenase-2 (COX-2) inhibition suppresses early fracture-healing, in vivo studies involving human subjects have not provided convincing evidence to substantiate this concern. We found no robust evidence to attest to a significant and appreciable patient detriment resulting from the short-term use of NSAIDs following a fracture. The balance of evidence in the available literature appears to suggest that a short-duration NSAID regimen is a safe and effective supplement to other modes of post-fracture pain control, without a significantly increased risk of sequelae related to disrupted healing.
非甾体抗炎药（NSAIDs）的镇痛效果已得到充分证实，这些药物通常是创伤后疼痛管理的重要组成部分。然而，有人提出，由此产生的前列腺素抑制对骨折愈合可能产生有害影响。
进行了系统的文献综述，包括电子数据库和在线资源的搜索，以确定探讨 NSAIDs 对骨折愈合影响的文章。
采用结构化搜索方法，确定了 316 篇可能与该主题相关的论文，并对其进行了手动审查。这些研究大多是小规模的、回顾性或观察性的，对潜在混杂因素的控制有限，或者提供的关键信息很少，而这些信息在其他研究中也有提到。
尽管越来越多的动物研究证据表明环氧化酶-2（COX-2）抑制会抑制早期骨折愈合，但涉及人类受试者的体内研究并未提供令人信服的证据来证实这一担忧。我们没有发现确凿的证据表明，骨折后短期使用 NSAIDs 会对患者造成明显且显著的损害。现有文献中的证据平衡似乎表明，短期 NSAID 治疗方案是骨折后疼痛控制其他方式的安全有效的补充，而不会显著增加与愈合中断相关的后遗症风险。
