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Tue Jul 15 07:55:11 BST 2008

Ken and Norman and others:

I spoke to our ortho trauma surgeons and they referred me to a recent
overview in the British Edition of JBJS (Inhibition of fracture healing
M S Gaston <javascript:void(0);> , A H R W Simpson <javascript:void(0);>
. Journal of Bone and Joint Surgery
<http://proquest.umi.com.ez.sun.ac.za/pqdweb?RQT=318&pmid=28785&TS=12161
04512&clientId=57290&VInst=PROD&VName=PQD&VType=PQD> . (British volume).
London: Dec 2007
<http://proquest.umi.com.ez.sun.ac.za/pqdweb?RQT=572&VType=PQD&VName=PQD
&VInst=PROD&pmid=28785&pcid=38287321&SrchMode=3&aid=1> . Vol. 89, Iss.
12; pg. 1553, 8 pgs). 

The section on NSAIDs has the following two human studies as references
suggesting that NSAID's delay healing significantly. I'm not necessarily
supporting the contention, just passing on the info.

 Burd TA, Hughes MS, Anglen JO. Heterotopic ossification prophylaxis
with indomethacin increases the risk of long-bone nonunion. J Bone Joint
Surg [Br] 2003;85-B:700-5.
 Giannoudis PV, MacDonald DA, Matthews SJ, et al. Nonunion of the
femoral diaphysis: the influence of reaming and non-steroidal
anti-inflammatory drugs. J Bone Joint Surg /flr/2000;82-B:655-8.

Regards
Tim
Dr Timothy C Hardcastle
M.B., Ch.B. (Stell); M. Med (Chir) (Stell); FCS (SA)
Principal Surgeon-Lecturer / Sub-specialist: Trauma and Critical Care
Deputy director: Trauma Unit and Trauma ICU
Inkosi Albert Luthuli Central Hospital / UKZN
800 Bellair Road
Mayville, Durban

Postal: PostNet Suite 27
Private Bag X05
Malvern, 4055
KwaZulu Natal

timothyhar at ialch.co.za 

-----Original Message-----
From: McSwain, Norman E Jr. [mailto:trauma-list-bounces at trauma.org] On
Behalf Of McSwain, Norman E Jr.
Sent: 15 July 2008 05:31
To: Trauma &amp
Subject: RE: NSAIDS

We discussed this in our trauma committee today. Many had heard
orthopedist make the same statement but none had any supporting data. I
can fine none either

Cathy Armstrong ask your source if they have ANY supporting data for
their statement and most especially enough for a ban for its use in the
entire trauma center.

Norman

Norman McSwain MD
Trauma Director, Charity Hospital
Professor of Surgery, Tulane University
New Orleans LA
504 988 5111
norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu> 

  _____  

From: trauma-list-bounces at trauma.org on behalf of Errington Thompson 
Sent: Mon 7/14/2008 4:02 PM
To: 'Trauma &amp; Critical Care mailing list'
Subject: RE: NSAIDS
I think that's all hooey.  In the early nineties there were tons of
studies
looking at pain relief and Toradol.  Are you telling me that there was a
significant non-union rate in those patients and NOBODY noticed?  Horse
hockey.  I think that something was found in rats or in the lab.  I have
pressed our Ortho guys to find any human data and I have received nada!

Errington C. Thompson, MD
Trauma/Surgical Critical Care
Talk Show Host - WPEK
www.whereistheoutrage.net
Asheville, NC

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]
On Behalf Of Janei D. Brockhausen
Sent: Monday, July 14, 2008 2:53 PM
To: Trauma &amp, Critical Care mailing list
Subject: Re: NSAIDS

I recently broke my tib/fib( OUCH- OUCH-OUCH) and was told no NSAIDS for
that reason. Hope to get my cast off this week after 9 weeks. janei

On 7/14/08, cathy armstrong <cathyarmstrong1 at googlemail.com> wrote:
>
> We have stopped NSAIDS in this patient population for over 3
years,same
> reason, interference with bone healing.
> simple paracetamol only.
> C Armstrong
> Anaesthesia
>
> On Mon, Jul 14, 2008 at 4:57 PM, Brian E. Fletcher <
> bfletcher at columbus.rr.com> wrote:
>
> >
> >
> > Hello,
> >
> > Recently our Level 1 Center has stopped using NSAIDS (ibubrofen,
> >  ketorolac)
> > for patients with long bone fractures and spinal fracture.   We have
> > stopped
> > using these drugs because of the risk for decrease healing.
> >
> > Do any of your facilities use NSAIDS in this patient population?
> > \
> > Brian Fletcher, Trauma Nurse Practitioner
> >
> >
> >
> > --
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