Ketorolac administered in the recovery room for acute pain management does not affect healing rates of femoral and tibial fractures

David Donohue, Drew Sanders, Rafa Serrano-Riera, Charles Jordan, Roger Gaskins, Roy Sanders, H. Claude Sagi

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objectives: To determine whether ketorolac administered in the immediate perioperative period affects the rate of nonunion in femoral and tibial shaft fractures. Design: Retrospective comparative study. Setting: Single Institution, Academic Level 1 Trauma Center. Patients: Three hundred and thirteen skeletally mature patients with 137 femoral shaft (OTA 32) and 191 tibial shaft (OTA 42) fractures treated with intramedullary rod fixation. Intervention: Eighty patients with 33 femoral shaft and 52 tibial shaft fractures were administered ketorolac within the first 24 hours after surgery (group 1 - study group). Two-hundred thirty-three patients with 104 femoral shaft and 139 tibial shaft fractures were not (group 2 - control group). Main Outcome Measurements: Rate of reoperation for repair of a nonunion and time to union. Results: Average time to union of the femur was 147 days for group 1 and 159 days for group 2 (P 0.57). Average time to union of the tibia was 175 days for group 1 and 175 days for group 2 (P 0.57). There were 3 femoral nonunions (9%) in group 1 and eleven femoral nonunions (11.6%) in group 2 (P 1.00). There were 3 tibial nonunions (5.8%) in group 1 and 17 tibial nonunions (12.2%) in group 2 (P 0.29). The average dose of ketorolac for patients who healed their fracture was 85 mg, whereas it was 50 mg for those who did not (P 0.27). All patients with a nonunion in the study group were current smokers. Conclusions: Ketorolac administered in the first 24 hours after fracture repair for acute pain management does not seem to have a negative impact on time to healing or incidence of nonunion for femoral or tibial shaft fractures. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)479-482
Number of pages4
JournalJournal of Orthopaedic Trauma
Volume30
Issue number9
DOIs
StatePublished - Sep 1 2016

Fingerprint

Ketorolac
Recovery Room
Tibial Fractures
Femoral Fractures
Acute Pain
Pain Management
Thigh
Perioperative Period
Trauma Centers
Tibia
Reoperation
Femur
Retrospective Studies
Control Groups
Incidence

Keywords

  • femoral shaft
  • nonsteroidal antiinflammatory drugs
  • nonunion
  • tibial shaft

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Ketorolac administered in the recovery room for acute pain management does not affect healing rates of femoral and tibial fractures. / Donohue, David; Sanders, Drew; Serrano-Riera, Rafa; Jordan, Charles; Gaskins, Roger; Sanders, Roy; Sagi, H. Claude.

In: Journal of Orthopaedic Trauma, Vol. 30, No. 9, 01.09.2016, p. 479-482.

Research output: Contribution to journalArticle

Donohue, David ; Sanders, Drew ; Serrano-Riera, Rafa ; Jordan, Charles ; Gaskins, Roger ; Sanders, Roy ; Sagi, H. Claude. / Ketorolac administered in the recovery room for acute pain management does not affect healing rates of femoral and tibial fractures. In: Journal of Orthopaedic Trauma. 2016 ; Vol. 30, No. 9. pp. 479-482.
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abstract = "Objectives: To determine whether ketorolac administered in the immediate perioperative period affects the rate of nonunion in femoral and tibial shaft fractures. Design: Retrospective comparative study. Setting: Single Institution, Academic Level 1 Trauma Center. Patients: Three hundred and thirteen skeletally mature patients with 137 femoral shaft (OTA 32) and 191 tibial shaft (OTA 42) fractures treated with intramedullary rod fixation. Intervention: Eighty patients with 33 femoral shaft and 52 tibial shaft fractures were administered ketorolac within the first 24 hours after surgery (group 1 - study group). Two-hundred thirty-three patients with 104 femoral shaft and 139 tibial shaft fractures were not (group 2 - control group). Main Outcome Measurements: Rate of reoperation for repair of a nonunion and time to union. Results: Average time to union of the femur was 147 days for group 1 and 159 days for group 2 (P 0.57). Average time to union of the tibia was 175 days for group 1 and 175 days for group 2 (P 0.57). There were 3 femoral nonunions (9{\%}) in group 1 and eleven femoral nonunions (11.6{\%}) in group 2 (P 1.00). There were 3 tibial nonunions (5.8{\%}) in group 1 and 17 tibial nonunions (12.2{\%}) in group 2 (P 0.29). The average dose of ketorolac for patients who healed their fracture was 85 mg, whereas it was 50 mg for those who did not (P 0.27). All patients with a nonunion in the study group were current smokers. Conclusions: Ketorolac administered in the first 24 hours after fracture repair for acute pain management does not seem to have a negative impact on time to healing or incidence of nonunion for femoral or tibial shaft fractures. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.",
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T1 - Ketorolac administered in the recovery room for acute pain management does not affect healing rates of femoral and tibial fractures

AU - Donohue, David

AU - Sanders, Drew

AU - Serrano-Riera, Rafa

AU - Jordan, Charles

AU - Gaskins, Roger

AU - Sanders, Roy

AU - Sagi, H. Claude

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N2 - Objectives: To determine whether ketorolac administered in the immediate perioperative period affects the rate of nonunion in femoral and tibial shaft fractures. Design: Retrospective comparative study. Setting: Single Institution, Academic Level 1 Trauma Center. Patients: Three hundred and thirteen skeletally mature patients with 137 femoral shaft (OTA 32) and 191 tibial shaft (OTA 42) fractures treated with intramedullary rod fixation. Intervention: Eighty patients with 33 femoral shaft and 52 tibial shaft fractures were administered ketorolac within the first 24 hours after surgery (group 1 - study group). Two-hundred thirty-three patients with 104 femoral shaft and 139 tibial shaft fractures were not (group 2 - control group). Main Outcome Measurements: Rate of reoperation for repair of a nonunion and time to union. Results: Average time to union of the femur was 147 days for group 1 and 159 days for group 2 (P 0.57). Average time to union of the tibia was 175 days for group 1 and 175 days for group 2 (P 0.57). There were 3 femoral nonunions (9%) in group 1 and eleven femoral nonunions (11.6%) in group 2 (P 1.00). There were 3 tibial nonunions (5.8%) in group 1 and 17 tibial nonunions (12.2%) in group 2 (P 0.29). The average dose of ketorolac for patients who healed their fracture was 85 mg, whereas it was 50 mg for those who did not (P 0.27). All patients with a nonunion in the study group were current smokers. Conclusions: Ketorolac administered in the first 24 hours after fracture repair for acute pain management does not seem to have a negative impact on time to healing or incidence of nonunion for femoral or tibial shaft fractures. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

AB - Objectives: To determine whether ketorolac administered in the immediate perioperative period affects the rate of nonunion in femoral and tibial shaft fractures. Design: Retrospective comparative study. Setting: Single Institution, Academic Level 1 Trauma Center. Patients: Three hundred and thirteen skeletally mature patients with 137 femoral shaft (OTA 32) and 191 tibial shaft (OTA 42) fractures treated with intramedullary rod fixation. Intervention: Eighty patients with 33 femoral shaft and 52 tibial shaft fractures were administered ketorolac within the first 24 hours after surgery (group 1 - study group). Two-hundred thirty-three patients with 104 femoral shaft and 139 tibial shaft fractures were not (group 2 - control group). Main Outcome Measurements: Rate of reoperation for repair of a nonunion and time to union. Results: Average time to union of the femur was 147 days for group 1 and 159 days for group 2 (P 0.57). Average time to union of the tibia was 175 days for group 1 and 175 days for group 2 (P 0.57). There were 3 femoral nonunions (9%) in group 1 and eleven femoral nonunions (11.6%) in group 2 (P 1.00). There were 3 tibial nonunions (5.8%) in group 1 and 17 tibial nonunions (12.2%) in group 2 (P 0.29). The average dose of ketorolac for patients who healed their fracture was 85 mg, whereas it was 50 mg for those who did not (P 0.27). All patients with a nonunion in the study group were current smokers. Conclusions: Ketorolac administered in the first 24 hours after fracture repair for acute pain management does not seem to have a negative impact on time to healing or incidence of nonunion for femoral or tibial shaft fractures. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

KW - femoral shaft

KW - nonsteroidal antiinflammatory drugs

KW - nonunion

KW - tibial shaft

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