Evidence map›Paper›PMID 42406158›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026

Preoperative ketorolac is associated with increased nonunion repair following femoral intramedullary nailing: a retrospective cohort study.

Joshua Wang, Carolyn Henein, Cameron Bowers, Philong Nguyen, Keenan Horani, William M Weiss

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Joshua WangJohn Sealy School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, USA. joswang@utmb.edu.
Carolyn HeneinJohn Sealy School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, USA.
Cameron BowersJohn Sealy School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, USA.
Philong NguyenJohn Sealy School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, USA.
Keenan HoraniDepartment of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch at Galveston, Galveston, USA.
William M WeissDepartment of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch at Galveston, Galveston, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNonsteroidal anti-inflammatory drugs (NSAIDs), including ketorolac, are widely used for perioperative analgesia, but their effects on bone healing remain debated. This study evaluates associations between preoperative intravenous ketorolac and outcomes on bone healing after femoral intramedullary nailing (IMN).

methodsUsing the TriNetX database, we conducted a retrospective cohort analysis of adults undergoing femoral IMN who received a single preoperative IV ketorolac dose. Propensity score matching (1:1) produced 2 cohorts (n = 8,466 each). Outcomes included wound disruption, infection, sepsis, thromboembolism, mortality, readmission, and nonunion/malunion repair. Risk ratios, 95% confidence intervals, and P values were calculated (P < 0.05).

resultsKetorolac was associated with increased wound disruption (P  = 0.034), and nonunion/malunion repair (P = 0.015), but decreased mortality (P = 0.014) and readmission (P = 0.009).

conclusionPreoperative ketorolac exposure was associated with higher rates of operative treatment of nonunion/malunion, although these findings should be interpreted cautiously because of substantial residual confounding and exposure misclassification. LEVEL OF EVIDENCE: Level III, Prognostic.

Indexed as

Anti-Inflammatory Agents, Non-SteroidalFemoral FracturesFracture Fixation, IntramedullaryFractures, UnunitedKetorolacAdultAgedFemaleFracture HealingFractures, MalunitedHumansMaleMiddle AgedPatient ReadmissionPostoperative ComplicationsPreoperative CareAnti-Inflammatory Agents, Non-SteroidalKetorolacFemurFracture fixationIntramedullary nailingKetorolacOutcome assessmentPostoperative complicationsPreoperative period

Identifiers

PMID42406158
PMCPMC13337603

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.