[Influence of unfractionated and low-molecular-weight heparin on bone healing: an animal model].
The inhibition of bone metabolism and development of osteoporosis under treatment with unfractionated heparins (UFH) have been discussed, whereas the pathomechanism and the question of whether low-molecular-weight heparins (LMWH) have an influence on bone healing as well remain unclear. In a blinded trial, three groups of ten rabbits received subcutaneous injections of an unfractionated heparin (sodium heparin), a low-molecular-weight heparin (certoparin), or normal saline over a period of 6 weeks after a standardized bone defect had been applied to both femur condyles. Healing of the defects was investigated in a depth of 1 and 2 mm and the remaining volume of the bone defects was measured. After therapy with UFH, the volume of the defects remained significantly larger in a depth of 1 mm (UFH/control: p<0.001; UFH/LMWH: p<0.005) and in the total depth (UFH/control: p<0.005; UFH/LMWH: p<0.025). After therapy with LMWH, there was no inhibition of defect healing (p>0.05). This study shows that the influence of heparins on fracture healing can be reduced significantly by using LMWH instead of UFH.
Kock
H J
HJ
Abteilung für Unfallchirurgie, Universität Essen, Germany.
Werther
S
S
Uhlenkott
H
H
Taeger
G
G
D000818:Animals; D001861:Bone Regeneration / Q000187:drug effects*; D005260:Female; D005264:Femoral Fractures / Q000473:pathology; D005269:Femur / Q000187:drug effects / Q000473:pathology; D017102:Fracture Healing / Q000187:drug effects*; D006493:Heparin / Q000494:pharmacology*; D006495:Heparin, Low-Molecular-Weight / Q000494:pharmacology*; D007279:Injections, Subcutaneous; D008856:Microscopy, Fluorescence; D010006:Osteoblasts / Q000187:drug effects / Q000473:pathology; D011817:Rabbits
D006495:Heparin, Low-Molecular-Weight; D006493:Heparin