Ibuprofen may help manage pain in pediatric fracture cases without delaying healing, according to a study.
The researchers randomized pediatric patients with long bone fracture to one of two groups. One group took weight-based ibuprofen. The other group was not allowed to take any nonsteroidal anti-inflammatory drugs (NSAIDs) and were given weight-based acetaminophen. The main outcome was fracture healing at two, six, and 10 weeks. Enrollment took place between Feb. 6, 2014, and Sept. 23, 2016.
Final analysis included 95 patients (97 fractures) who completed six months of follow-up: 49 patients (50 fractures) in the NSAID group and 46 patients (47 fractures) in the control group. None of the patients in either group achieved healing at two weeks. At six weeks, a greater proportion of patients in the NSAID group achieved healing than the control group (n=46/50 [92%] vs. n=37/45 [82%]; P=0.22). At 10- to 12-week follow-up, all fractures in the ibuprofen group and 98% in the control group were healed; at six months, all fractures were completely healed. The mean time to healing in the ibuprofen group was 31 days and in the control group was 40 days (P=0.76). Breakthrough oxycodone was used a mean 1.9 days in the NSAID group and 2.4 days in the control group (P=0.48).
The study was published in the Journal of Pediatric Orthopaedics.
“The findings of this study are relevant for a wide variety of practitioners,” said study author Sumit Gupta, MD, in a press release. “I think this study will be especially important when the patient first presents to the emergency department. The physician there should feel comfortable prescribing ibuprofen in addition to acetaminophen as a safe and effective pain reliever that won’t hinder a child’s bone healing.”
Dr. Gupta, who is an associate professor of orthopaedic surgery at the MU School of Medicine, said that acetaminophen is often not enough to manage pain in pediatric fracture cases and that better responses are typically achieved when patients have two medications. “So if that second medication can be ibuprofen instead of a narcotic, that’s a much safer alternative,” said Dr. Gupta.