FONDAPARİNUKSUN KIRIK İYİLEŞMESİNE GERÇEKTEN POZİTİF ETKİSİ VAR MIDIR? SIÇANLAR ÜZERİNDE YAPILAN DENEYSEL BİR ÇALIŞMA

AMAÇ: Antiembolik ajanlar ortopedi ve travmatoloji kliniklerin-de özellikle artroplasti, tümör ve travma cerrahilerinde embolizm problemlerini azaltmak için rutin olarak kullanılmaktadır. Fonda-parinuks’un kırık iyileşmesi üzerine etkisi belirsizdir. Bu çalışmanın amacı sıçan modeli kullanarak fondaparinuksun kırık iyileşmesi üzerine etkisinin incelenmesi ve enoksaparinin etkisi ile karşılaş-tırılmasıdır. GEREÇ VE YÖNTEM: 64 adet Wistar-Albino sekiz gruba randomize olarak ayrıldı. Genel anestezi altında sol femur kapalı standart kırıkları oluşturuldu. Kontrol grupları (A, B), heparin grupları (C, D), enoksaparin grupları (E, F), ve fondaparinuks grupları (G, H), sırasıyla izotonik NaCl (1cc/gün), heparin (1000 anti Xa IU/kg/gün), enoksaparin (100 anti Xa IU/kg/gün) ve fondaparinuks (0.2mg/kg/ gün) olacak şekilde 14 gün süre ile uygulandı. A, C, E, G gruplarındaki sıçanlar postoperatif 14. günün, B, D, F, H gruplarındakiler ise 28. günün sonunda sakrifiye edildiler. Tüm femurların radyolojik incelemesi standart ön-arka ve yan grafiler kullanılarak Goldberg sınıflamasına göre yapıldı. Histolojik inceleme ise Huo histolojik iyileşme sınıflamasına göre yapıldı. Bu çalışmanın istatiksel analizleri GraphPad Prisma V.3 paket programı kullanılarak yapıldı. Sonuçlarda anlamlılık p0.05). SONUÇ: Çalışmamızda fondaparinuksun enoksaparin ile karşılaş-tırıldığında kırık iyileşmesi üzerine herhangi ekstra olumlu etkisini saptamadık. Fondaparinuks uygulamasının kırık iyileşmesi üzerine negatif bir etkisi saptanmamış olması nedeniyle travma vakaların-da embolizm problemlerini önlemede kullanılabileceği kanaatin-deyiz.

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

OBJECTIVE: Antiembolic agents are routinely used in orthopaedics and traumatology clinics especially in arthrop-lasty, tumor and trauma surgery to decrease the embolism prob-lems. The effect of fondaparinux on fracture healing is unclear. The aim of this study is to find out the effect of fondaparinux on frac-ture healing and to compare with the effect of enoxaparin using a rat model. MATERIALS AND METHODS: 64 Wistar-Albino rats were randomi-zed into eight groups. Standard closed left femur fractures crea-ted under general anaesthesia. The control groups (A, B), heparin groups (C, D), enoxaparin groups (E, F), and fondaparinux groups (G, H), which administered isotonic NaCl solution (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 were sacrificed at the end of day14 and the rats in groups B, D, F, H were scarified at the end of day 28 postopera-tively. All the femurs were radiologically evaluated with standard AP and lateral X-rays of the sacrificed femurs were rated according to the Goldberg classification system. Histological classification of healing was done according to Huo’s histological healing sca-le. Statistical analysis in this study was performed with GraphPad Prisma V.3 package software. Significance in the results were eva-luated at the level of p

Kaynakça

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