Comparison of the effects of dexketoprofen trometamol, meloxicam and diclofenac sodium on fibular fracture healing, kidney and liver: an experimental rat model.
OBJECTIVE
Nonsteroidal anti-inflammatory drugs (NSAIDs) are particularly used in patients with bone fractures, but there are limited studies on whether one NSAID is superior to another. In this study, we used histopathological and biochemical parameters to determine whether there are differences between the effects of the administration of clinical doses of dexketoprofen trometamol (DEXT), meloxicam (MEL) and diclofenac sodium (DIC) on the healing of closed fibular fractures and the toxicity of both the liver and kidney.


METHODS
Twenty-eight male Sprague-Dawley rats were randomly divided into four groups of seven each. Closed diaphyseal fractures were formed in the left fibulas of all of the rats. The NSAIDs dexketoprofen trometamol (DEXT) (Arveles(®)), meloxicam (MEL) (Melox(®)) and diclofenac sodium (DIC) (Voltaren(®)) were intramuscularly administered to Groups I, II, and III, respectively, for a period of 10 days after the fibular fractures were performed. No pharmacological agents were administered to Group IV (Control group). Blood samples were collected from all of the rats after the fractures were performed, and the rats were sacrificed on day 28. The histopathological findings were compared, and the blood samples were evaluated to determine any differences between the levels of superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA).


RESULTS
Our results suggest that DEXT and MEL impair the healing of bone fractures and that DIC does not histopathologically affect the healing process of bone fractures. We also found that DEXT, MEL, and DIC impaired the renal histopathology compared with the control group. However, the liver histopathological analysis showed that DEXT and MEL caused a higher degree of parenchymal necrosis compared with DIC.


CONCLUSIONS
Based on our results, DIC can be considered a relatively safe medication in patients with fractures.
Department of Orthopaedics and Traumatology, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey. Electronic address: sermetinal@yahoo.com.tr.
Sermet
S
Inal
Department of Urology, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey. Electronic address: skabay@yahoo.com.
Sahin
S
Kabay
Department of Biology, Faculty of Arts and Science, Dumlupinar University, Kutahya, Turkey. Electronic address: kcayci@dumlupinar.edu.tr.
M Kasim
MK
Cayci
Department of Medical Laboratory Techniques, Simav Vocational High School, Dumlupinar University, Turkey. Electronic address: halilisakuru@yahoo.com.
H Isa
HI
Kuru
Department of Biochemistry, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey. Electronic address: saitaltikat@hotmail.com.
Sayit
S
Altikat
Department of Pathology, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey. Electronic address: dr.gizemakkas@gmail.com.
Gizem
G
Akkas
Department of Pathology, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey. Electronic address: ayhade@yahoo.com.
Aysenur
A
Deger
D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology*; D001696:Biomechanical Phenomena; D004008:Diclofenac / Q000494:pharmacology*; D005360:Fibula / Q000187:drug effects / Q000293:injuries / Q000473:pathology*; D017102:Fracture Healing / Q000187:drug effects*; D050723:Fractures, Bone / Q000188:drug therapy / Q000473:pathology*; D007249:Inflammation; D007660:Ketoprofen / Q000031:analogs & derivatives* / Q000494:pharmacology; D007668:Kidney / Q000187:drug effects* / Q000473:pathology; D008099:Liver / Q000187:drug effects* / Q000473:pathology; D008297:Male; D000077239:Meloxicam; D018384:Oxidative Stress; D010146:Pain / Q000188:drug therapy; D051381:Rats; D017207:Rats, Sprague-Dawley; D013843:Thiazines / Q000494:pharmacology*; D013844:Thiazoles / Q000494:pharmacology*; D014325:Tromethamine / Q000494:pharmacology*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D013843:Thiazines; D013844:Thiazoles; D014325:Tromethamine; D004008:Diclofenac; D007660:Ketoprofen; C118296:dexketoprofen trometamol; D000077239:Meloxicam
Anti-inflammatory agents; Fracture healing; Kidney; Liver; Non-steroidal