Influence of Ibuprofen on Bone Healing After Colles' Fracture: A Randomized Controlled Clinical Trial

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DOI

  • Marius Aliuskevicius, Aalborg Hospital
  • ,
  • Svend Erik Østgaard
  • Ellen Margrethe Hauge
  • Peter Vestergaard, Aalborg University Hospital, Aalborg Hospital
  • ,
  • Sten Rasmussen, Department of Orthopedic Surgery, Aalborg Hospital, Aalborg University Hospital

Non-steroidal anti-inflammatory drugs (NSAIDs) may delay bone healing. [Therefore, it is important to establish whether NSAID preparations delay bone healing and what correlations, if any, exist between different bone studies—DEXA—scanning, bone markers, roentgenology controls, and histological examination of newly formed bone]. The purpose of this prospective controlled study was to investigate whether ibuprofen affects bone mineral density, turnover biomarkers, and histomorphometric characteristics of the callus after a Colles' fracture. This study was a single-center, triple-blinded, randomized clinical trial. Ninety-five patients (80 females) with displaced Colles' fracture, median age 65 (range 40–85) years were included in the study and operated on by external fixation from June 2012 through to June 2015. Eighty-nine patients received interventional medicine and 83 completed the 1-year follow-up. The 7-day ibuprofen group received 600 mg of ibuprofen three times a day (N = 29), the 3-day ibuprofen group received ibuprofen for 3 days (N = 30) and a placebo for the following 4 days, and finally, the placebo group received a placebo for 7 days (N = 30). The primary outcome was the difference in bone mineral density between the ultra-distal region of the injured and non-injured radius at 3 months after surgery. The histomorphometric outcomes included the assessment of callus tissue volume and surface fractions at 6 weeks postoperatively. The biomarkers Osteocalcin and CrossLaps were measured at baseline, 1 week, 2 weeks, 6 weeks, 3 months, and 1 year. We included the results of the dropped-out patients in the intention to treat analysis. There was no difference between treatment groups in bone mineral density, histomorphometric estimations, and changes in bone biomarkers. These findings may offer an indication of ibuprofen as a bone-safe analgesic treatment in an acute fracture-phase.

Original languageEnglish
JournalJournal of Orthopaedic Research
Volume38
Issue3
Pages (from-to)545-554
Number of pages10
ISSN0736-0266
DOIs
Publication statusPublished - 2020

    Research areas

  • bone biomarkers, callus histomorphometry, DXA scanning, fracture, ibuprofen

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