Effect of perioperative administration of selective cyclooxygenase 2 inhibitors on fracture healing of middle tibia and fibula

Abstract

Objective To study the effect of perioperative administration of selective cyclooxygenase (COX-2) inhibitors (Celebrex and Parecoxib) on fracture healing of middle tibia and fibula.Methods The patients with fracture of middle tibia and fibula were enrolled in the present study who were admitted to our department from October 2008 to October 2009.The control group had 55 patients,35 males and 20 females,with an average age of 35.5 ± 2.4 years.The study group had 52 patients,30 males and 22 females,with an average age of 34.6 ± 3.2 years.Selective COX-2 inhibitors were used for perioperative analgesia in the study group but not in the control group.At 1,2,3,4,6,8,12 and 18 months postoperation,the 2 groups were observed for cases of significant callus at the fracture end and of disappearance of fracture line.The 2 groups were compared in terms of time of callus formation,time of fracture line disappearance and time of fracture healing.Results The 107 patients obtained an average follow-up of 22 months (from 18 to 30 months).Callus formation at the fracture end was observed in 7,15,52 and 55 cases respectively at 1,2,3,4 months postoperation in the control group,and in 6,13,49 and 52 cases in the study group.Disappearance of fracture line was observed in 3,42,53 and 55 cases respectively at 6,8,12,18 months postoperation in the control group,and in 2,38,49 and 52 cases in the study group.There were no significant differences between the 2 groups regarding all the above indexes (P ＞ 0.05).The average fracture healing time was 10.0 ± 2.3 weeks for the control group and 10.2 ± 2.5 weeks for the study group,with no significant difference(t=0.689,P=0.425).No nonunion occurred in either group.Conclusion Short-termadministra-tion of selective COX-2 inhibitors in clinic has no obvious effect on the fracture healing of middle tibia and fibula. Key words: Intraoperative period; Cyclooxygenase 2 inhibitors; Fracture healing; Tibial fractures