DOES FONDAPARINUX HAVE REALLY POSITIVE EFFECT ON FRACTURE HEALING? AN EXPERIMENTAL STUDY IN RATS

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OBJECTIVE: Antiembolic agents are routinely used inorthopaedics and traumatology clinics especially in arthroplasty,tumor and trauma surgery to decrease the embolismprob-lems. The effect of fondaparinux on fracture healing isunclear. The aim of this study is to find out the effect offondaparinux on frac-ture healing and to compare with the effectof enoxaparin using a rat model.MATERIALS AND METHODS: 64 Wistar-Albino rats wererandomi-zed into eight groups. Standard closed left femurfractures crea-ted under general anaesthesia. The control groups(A, B), heparin groups (C, D), enoxaparin groups (E, F), andfondaparinux groups (G, H), which administered isotonic NaClsolution (1cc/day), hepa-rin (1000 anti Xa IU/kg/day),enoxaparin (100 anti Xa IU/kg/day) and fondaparinux (0.2mg/kg/day) respectively for 14 days. The rats in groups A, C, E, G weresacrificed at the end of day14 and the rats in groups B, D, F, Hwere scarified at the end of day 28 postopera-tively. All thefemurs were radiologically evaluated with standard AP andlateral X-rays of the sacrificed femurs were rated according to theGoldberg classification system. Histological classification ofhealing was done according to Huo’s histological healing sca-le.Statistical analysis in this study was performed with GraphPadPrisma V.3 package software. Significance in the results wereeva-luated at the level of p 0.05.RESULTS: Radiological evaluation did not reveal any significant differencebetween the groups in the second and the fourth weeks.Histological callus formation was found to be significantly poorerin the heparine group compared to other groups at the end of thefourth week. No significant differences were found between thegroups histologically except the heparin group. Besides that, therewas no significant difference on fracture healing radiologically andhistologically between the enoxaparine and fondaparinux groups.CONCLUSION: We did not detect any extra positive effect of fondaparinuxon fracture healing compared to enoxaparin. But fondaparinuxcan be used to prevent embolism problems in traumaticcases as the application of fondaparinux has no negative effect bone healing.

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Fracture healing , Fondaparinux , Enoxaparin , Heparin , Rat

Kocatepe Medical Journal

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Kocatepe Medical Journal