The use of indomethacin in the prevention of postoperative radioulnar synostosis after distal biceps repair

Background This study evaluated the incidence of symptomatic radioulnar synostosis/heterotopic ossification after distal biceps tendon repair in patients receiving indomethacin prophylaxis. We hypothesized that indomethacin use postoperatively would decrease the occurrence of symptomatic synostosis. Methods A single-center retrospective record review identified 124 patients undergoing distal biceps repair between 2011 and 2014. Patients were analyzed for administration of indomethacin, contraindications to administration, age, time to surgery, fixation method, medical comorbidities, and development of symptomatic synostosis. Oral indomethacin (75 mg, once daily) was prescribed postoperatively for 10 to 42 days per each attendings' protocol. Results After analysis, 112 patients met the inclusion criteria, with 7 undergoing a 1-incision distal biceps repair and 105 undergoing a 2-incision repair. Of those, 104 received indomethacin postoperatively, with a synostosis rate of 0.96% compared with 37.50% for the untreated group ( P