Table 1

Studies reporting on efficacy and safety of NSAIDs after orthopedic fracture in adult patients

Author (ID)State or countryYearStudy designStudy sizePatient population (types of fractures and surgery)NSAIDs usedDuration (time or doses)Indication for NSAIDsOutcomes measured
Mehta23India1986Randomized control trial254Long bone fractures who underwent fixationDipyrone (500 mg) or ASA (500 mg)One dosePain controlPain
Hunter22USA2020Retrospective cohort502Malleolar ankle fractures who underwent fixationASA (325 mg)Daily for 6 to 8 weeksDVT prophylaxisNon-union
Moed21USA1984Retrospective cohort35Acetabular fractures who underwent fixationIndomethacin (25 mg)TID for 6 weeksPrevent HONon-union
Jeffcoach19USA2014Retrospective cohort193Femur, tibia and/or humeral fractures8 different NSAIDsIQR 1.0 to 8.5 dosesPain controlNon-union
Buchheit18USA2018Retrospective cohort309 330Bone fracture in year 2011Any NSAID, dose not reportedAcute (<30 days)
Chronic (≥30 days)
Not reportedNon-union
Adolphson17Sweden1993Randomized control trial33Colles’ fracture in postmenopausal womenPiroxicam (20 mg)Daily for 8 weeksReduction in osteopeniaPain
Weisz16USA2021Randomized control trial99Fracture of ribs, face, extremities or pelvisIV Ibuprofen (800 mg)Eight doses over 2 daysPainPain, OMEs
Sagi15USA2014Randomized control trial98Acetabular fractures who underwent fixationIndomethacin (75 mg)Daily for 3 days, 1 week or 6 weeksPrevent HONon-union
McDonald14USA2019Randomized control trial128Ankle fractures who underwent operative treatmentKetorolac 30 mg IV intra-op+20 tabs Ketorolac 10 mg7 daysPainPain, OMEs, non-union
Burd13USA2003Randomized control trial112Acetabular fractures who underwent fixationIndomethacin (25 mg)Three times a day for 6 weeksPrevent HONon-union
Zura12USA2016Retrospective cohort309 330Bone fracture in year 2011Any NSAID, dose not reportedNot reportedNot reportedNon-union
Ortiz10Mexico2010Randomized control trial49Ankle fracture and pain >5/10Ketorolac (10 mg)
Diclofenac (70 mg)
Etoricoxib (60 mg)
Two dosesPainPain
Bayouth9USA2013Retrospective cohort (matched)42Rib fracturesIV Ibuprofen600 to 800 mg every 6 hoursPainPain, OMEs
Eftekharian8Iran2017Randomized clinical trial50Mandibular fractureKetorolacSingle postoperative dosePainPain
Xu7USA2016Randomized clinical trial63Femoral or tibiofibular fracturesKetorolacIn postoperative analgesia pumpPainPain, OMEs
Tucker6USA2020Retrospective cohort17 689Operatively treated long-bone fracturesNSAID
Up to 90 daysNot reportedNon-union
Aliuskevicius3Denmark2021Randomized control trial96Non-surgically treated Colles’ fracturesIbuprofen3 days or 7 daysPain controlPain
Haines5USA2020Retrospective cohort190 057≥65 year old who underwent hip or femur fixation for fractureAny NSAIDNot reportedNot reportedOMEs, acute kidney injury
George4USA2020Retrospective cohort339 864Single long-bone fracture or commonly paired long-bone fracturesAny NSAID, dose not reported; COX-2 or non-selectiveNot reportedNot reportedNon-union
  • †Institution specific.

  • ‡For both groups combined.

  • ASA, aspirin; DVT, deep vein thrombosis; HO, heterotopic ossification; NSAIDS, non-steroidal anti-inflammatory drugs; OME, oral morphine equivalents.