The Effect of Opioids, Alcohol, and Nonsteroidal Anti-inflammatory Drugs on Fracture Union

Orthop Clin North Am. 2017 Oct;48(4):433-443. doi: 10.1016/j.ocl.2017.06.002. Epub 2017 Jul 29.

Abstract

The estimated rate of fracture nonunion is between 5% and 10%, adding significant cost to the health care system. The cause of fracture nonunion is multifactorial, including the severity of the injury, patient factors resulting in aberrancies in the biology of fracture, and the side effects of pain control modalities. Minimizing surgeon-controlled factors causing nonunion is important to reduce the cost of health care and improve patient outcomes. Opioids, alcohol, and nonsteroidal anti-inflammatory drugs have been implicated as risk factors for fracture nonunion. Current literature was reviewed to examine the effects of opioids, alcohol, and nonsteroidal anti-inflammatory drugs on fracture union.

Keywords: Alcohol; Fracture; NSAIDs; Nonunion; Opioids.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use
  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Ethanol / adverse effects*
  • Ethanol / therapeutic use
  • Fracture Healing / drug effects*
  • Fractures, Bone / complications*
  • Humans
  • Pain / drug therapy*
  • Pain / etiology
  • Risk Factors

Substances

  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Ethanol