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 lactating at time of screening Patients with a bone graft procedure planned for a future date at the time of initial definitive fixation surgery.