Postoperative Aspirin Use is Associated with Delayed Progression of Radiographic Healing in Tibial Fractures Treated with Internal Fixation

3 Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA The clinical role of prostaglandins in fracture healing has yet to be fully elucidated. Data from animal models have shown that some nonsteroidal anti-inflammatory medications (NSAIDs) inhibit fracture healing. However, a clear clinical association between prostaglandin inhibition and delayed fracture healing has not been established. Specifically, the effects of acetylsalicylic acid (ASA) on fracture healing are unknown. The goal of our study was to test the relationship between postoperative ASA use and progression of radiographic healing of tibial fractures acutely treated with internal fixation. Thirty-five radiographs of consecutive tibial shaft fractures (OTA/AO 42) treated with intramedullary fixation were prospectively reviewed and graded for healing. Least square regression modeling was used to assess if an effect of postoperative ASA use on radiographic healing grade over time was present. Patients with and without ASA treatment had similar demographic and injury parameters. Our data show that ASA treatment had a statistically significant effect on fracture healing that decreased radiographic callus formation when compared to patients not receiving ASA postoperatively. Progression of time increased radiographic grade. Age was not associated with healing progression. Our data suggest postoperative administration of ASA delays progression of radiographic fracture healing in tibial fractures treated with intramedullary fixation. This data supports the notion that prostaglandin inhibition may have a negative effect on proper bony healing. Our results stress the importance of further study regarding the role of prostaglandin inhibition on clinical fracture healing.