ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2022
Non-union and use of proton pump inhibitors in the treatment of femoral and tibial shaft fractures: a nested case-control study.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Perioperative Proton Pump Inhibitors Versus H2-Receptor Antagonists and 1-Year Complications After Distal Radius ORIF: A Propensity-Matched Cohort Study.Journal of hand surgery global online · 2026Article
- Systemic Lipid Metabolism Dysregulation as a Possible Driving Force of Fracture Non-Unions?Bioengineering (Basel, Switzerland) · 2024Article
- Development and validation of predictive nomogram for postoperative non-union of closed femoral shaft fracture.Scientific reports · 2024Article
- The correlates of post-surgical haematoma in older adults with proximal femoral fractures.Aging clinical and experimental research · 2023Article
- Bone Healing Gone Wrong: Pathological Fracture Healing and Non-Unions-Overview of Basic and Clinical Aspects and Systematic Review of Risk Factors.Bioengineering (Basel, Switzerland) · 2023Review
- Proton Pump Inhibitors and the Risk of Early Aseptic Loosening in Hip and Knee Arthroplasty.Geriatric orthopaedic surgery & rehabilitation · 2022Article
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Authors and funding
8 authors.
Funding
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Abstract
backgroundProton pump inhibitors (PPIs) are one of the most frequently used drugs worldwide. Previous research has shown that they could increase the risk of fracture and interfere with the fracture healing process. In this study, we analyzed the effect of PPIs on the risk of fracture non-union in patients with femoral and tibial shaft fractures.
methodsA case-control study was conducted at our institution, including a total of 254 patients who underwent fixation surgery for a femoral or tibial shaft fracture between January 2012 and December 2017. We defined cases as patients who experienced a delayed union (case group A; n = 44), or non-union (cases group B; n = 12). Cases were matched by age, sex, and fractured bone, to 144 controls who did not experience delayed fracture union and did not require further procedures. A conditional logistic regression analysis was performed adjusted to potential confounders, and to the proportion of days covered (PDC) with PPIs.
resultsAdjusted ORs (95% CI) for undergoing a nail dynamization following a tibial or femoral shaft fracture were 1.38 (0.70-2.65) for any use PPIs. Patients with a longer PPI treatment courses (PDC ≥ 0.5) had an adjusted OR of 1.86 (0.70-4.76) for undergoing nail dynamization when compared with controls. Contrastingly, patients with a PDC < 0.5 had an adjusted OR of 1.03 (0.43-2.48). The adjusted OR (95% CI) for undergoing additional surgical procedures due to non-union was 4.5 (0.62-32.8) for any use of PPIs, and 12.3 (1.9-81.0) in patients with a PDC ≥ 0.5.
conclusionsA prolonged use of PPIs use was associated with a higher risk of fracture non-union in tibial and femoral shaft fractures.
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