AAHS - Increased Rate of Distal Radius Nonunion Associated with NSAID Use Within Thirty Days of Fracture

Back to 2026 ePosters

Increased Rate of Distal Radius Nonunion Associated with NSAID Use Within Thirty Days of Fracture
Andrew Jae-Min Park, MD, Christopher M Dussik, MD, Amy Phan, MD, Jeffrey Coombs, MD; Constantinos Ketonis, MD, PhD
University of Rochester Medical Center, Rochester, NY

Purpose: Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently employed in the management of distal radius fractures (DRFs) to mitigate swelling and control pain. The theoretical risk of disrupted bone healing has been previously described, but the literature is limited to single-institution studies with small sample sizes. The purpose of this study was to determine whether NSAID exposure influences nonunion rates in patients with DRFs managed operatively and nonoperatively, by leveraging a large, multicenter registry.

Methods: An analysis was conducted using the TriNetX database to compare the rate of nonunion for operatively and nonoperatively treated DRFs with and without prescribed NSAIDs. The cohorts were matched based on age, sex, ethnicity, and various comorbidities. Odds ratios were calculated to assess statistical significance.

Results: A total of 394,022 nonoperatively and 75,693 operatively treated DRFs were included. Of those, 83,134 nonoperative and 30,262 operative DRFs were prescribed NSAIDs up to one month after diagnosis. In the nonoperative cohort, the nonunion rate for the NSAIDs group was 0.41% versus 0.15% for the non-NSAIDs group whereas in the operative cohort, the corresponding nonunion rates were 0.70% in the NSAID group compared to 0.51% for the non-NSAIDs group.. The risk difference was statistically significant for both cohorts (p < 0.05). After matched analysis, NSAIDs were associated with an increased risk of nonunion in both operatively and nonoperatively treated DRFs, with a 1.35 (95% CI: 1.1-1.6) and 2.32 (95% CI: 1.93-2.80) odds ratio, respectively.

Conclusions: NSAID administration was associated with an increased risk of nonunion in both nonoperatively and operatively treated DRFs.

Back to 2026 ePosters