Effect of NSAIDs on Union, Opioid Utilization and Pain Management for Tibia Fractures

Inclusion Criteria: * All patients with open (Grade I, II, of IIIa) or closed tibia fractures treated with a nail. * Patients 18-80 years old inclusive. * Patients able to be followed at a Major Extremity Trauma \& Rehabilitation (METRC) facility for at least 12 months following injury Exclusion Criteria: * Patient unable to provide informed consent * Patients who are current - intravenous drug user. * Patients with a history of allergy to the study drugs. * Patients unable to swallow oral medications or without functioning GI tract. * Patients with a history of gastrointestinal bleeds or gastric perforation. * Patients with a history of stroke or heart attack. * Patients requiring an aspirin or NSAID regimen except for low dose aspirin, 81mg. * Patients with any bleeding disorders. * Patients with severe renal failure \[glomerular filtration rate (GFR):\<30\]. Patients with moderate renal failure \[GFR: 30-59\] may participate in the study at a modified dose. * Patients undergoing daily treatment with systemic glucocorticoids before surgery. * Patients likely to have severe problems maintaining follow-up, including patients diagnosed with a severe psychiatric conditions, patients who live too far outside the hospital's catchment area, patients who are incarcerated and patients who have unstable housing situations. * Patients with a Glasgow Coma Scale (GCS) \<15 at discharge. * Patients with a closed head injury that precludes NSAIDS. * Patients who are pregnant or lactati…