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Postoperative aspirin use and its effect on bone healing in the treatment of ankle fractures.
- Source :
-
Injury [Injury] 2020 Feb; Vol. 51 (2), pp. 554-558. Date of Electronic Publication: 2019 Nov 26. - Publication Year :
- 2020
-
Abstract
- Background: There is hesitancy to administer nonsteroidal anti-inflammatories (NSAIDs) within the postoperative period following fracture care due to concern for delayed union or nonunion. However, aspirin (ASA) is routinely used for chemoprophylaxis of deep vein thrombosis (DVT) and is gaining popularity for use after treatment of ankle fractures. The current study examines the incidence of nonunion of operative ankle fractures and risk of DVT in patients who did and did not receive postoperative ASA.<br />Methods: A retrospective chart review was performed on all patients treated between 2008 and 2018 for ankle fractures requiring operative fixation by three Foot and Ankle fellowship trained orthopaedic surgeons at a single institution. Demographics, preoperative comorbidities, and postoperative medical and surgical complications were compared between patients who did and did not receive ASA postoperatively. For both groups, union was evaluated by clinical exam as well as by radiograph, for those with 6-week, 12-week, or 24-week follow-up.<br />Results: Five-hundred and six patients met inclusion criteria: 152 who received ASA and 354 who did not. Radiographic healing at six weeks was demonstrated in 95.9% (94/98) and 98.6% (207/210) respectively (p-value .2134). There was no significant difference in time to radiographic union between groups. The risk of postoperative DVTs in those with and without ASA was not significantly different (0.7% (1/137) vs 1.2% (4/323), respectively; p-value .6305).<br />Conclusion: Postoperative use of ASA does not delay radiographic union of operative ankle fractures or affect the rate of postoperative DVT. This is the first and largest study to examine the effect of ASA on time to union of ankle fractures.<br />Level of Evidence: III.<br />Competing Interests: Declaration of Competing Interest No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.<br /> (Copyright © 2019. Published by Elsevier Ltd.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Animals
Ankle Fractures diagnostic imaging
Anti-Inflammatory Agents, Non-Steroidal therapeutic use
Aspirin therapeutic use
Case-Control Studies
Female
Fracture Fixation, Internal methods
Fractures, Ununited diagnostic imaging
Fractures, Ununited epidemiology
Humans
Incidence
Male
Middle Aged
Models, Animal
Outcome Assessment, Health Care
Postoperative Care statistics & numerical data
Postoperative Period
Rabbits
Radiography methods
Rats
Retrospective Studies
Venous Thrombosis epidemiology
Venous Thrombosis prevention & control
Young Adult
Ankle Fractures surgery
Anti-Inflammatory Agents, Non-Steroidal adverse effects
Aspirin adverse effects
Fracture Healing drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0267
- Volume :
- 51
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Injury
- Publication Type :
- Academic Journal
- Accession number :
- 31806383
- Full Text :
- https://doi.org/10.1016/j.injury.2019.11.039