Do non-steroidal anti-inflammatory medications or opioids increase the risk of nonunion after surgical and nonsurgical treatment of tibial shaft fractures?

Background: Nonsteroidal anti-inflammatory drug (NSAID) medications have been implicated in fracture nonunion. However, the evidence to date for this association is limited, due in part to the rarity of the outcome. Prior investigations may not sufficiently account for confounding, limiting the ability to draw accurate conclusions regarding the independent association of NSAID exposure with subsequent nonunion rates. Opioids are often used instead of NSAIDs to treat postoperative pain, but the association between opioid use and nonunion risk is unclear. The purpose of this study was to investi

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