Effect of nonsteroidal antiinflammatory drugs on fracture healing: a laboratory study in rats.
We studied the effects of two nonsteroidal antiinflammatory drugs (NSAIDs) on fracture healing in rats: ibuprofen (30 mg/kg/day) and indomethacin (1 mg/kg/day). Femoral fractures were induced via a three-point bending technique. NSAIDs were administered orally for 4 or 12 weeks. Control animals received no medication. In each group a minimum of six animals were killed at the following intervals: 2, 4, 6, 8, 10, and 12 weeks postfracture. Fracture healing was determined by mechanical testing and histologic evaluation. The bending strength of each fractured femur was expressed as a percentage of the strength of the intact, contralateral femur. Histologic evaluation was performed on serial longitudinal sections stained with hematoxylin and eosin using a qualitative score of maturity of the callus. Ibuprofen and indomethacin both retarded fracture healing, with significant differences in "mechanical healing" found between the control and experimental groups after 10 weeks of drug administration. Both drugs also induced qualitative histologic changes manifested by delayed maturation of callus, which was noticeable earlier than the difference found by mechanical testing of bone. Our data suggest that NSAIDs have an inhibitory effect on fracture repair that is reversible after cessation of indomethacin but not ibuprofen.
Department of Medicine, University of Miami School of Medicine, Veterans Administration Hospital, Florida 33101, USA.
R D
RD
Altman
L L
LL
Latta
R
R
Keer
K
K
Renfree
F J
FJ
Hornicek
K
K
Banovac
D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology*; D001696:Biomechanical Phenomena; D002146:Bony Callus / Q000473:pathology; D005260:Female; D005264:Femoral Fractures / Q000473:pathology / Q000503:physiopathology*; D017102:Fracture Healing / Q000187:drug effects*; D007052:Ibuprofen / Q000494:pharmacology*; D007213:Indomethacin / Q000494:pharmacology*; D051381:Rats
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen; D007213:Indomethacin