비 steroid성 소염진통제가 흰쥐의 대퇴골 골절치유에 미치는 영향 = Effects of non-steroidal anti-inflammatory drugs on bone healing of femoral fractures in albino rats

다국어 초록 (Multilingual Abstract)

More concern has been concentrated in the effects on fracture healing of nonsteroidal anti-inflammatory drugs which has generally been used to reduce pain and edema in the inflammatory regions. Recently many investigators have reported that anti-inflammatory drugs such as aspirin, ibuprofen and indomethacine bring about delay in bone healing following the fracture. The cause of delay in bone healing by treating anti-inflammatory drugs was presumably explained by the fact that the inhibition of synthesis or secretion of prostaglandins produced disturbances in clothing, organization, collagen synthesis and calcification taking place after the fracture.
In the present study an experiment was carried out to substantiate the mechanism by which anti-inflammatory drugs delayed bone-healing following the fracture.
Wistar rats weighing approximately 200gm were artificially made closed-fracture in femur shaft and were divided into three experimental groups; control, aspirintreated and ibuprofen-treated groups. The anti-inflammatory drugs were administered daily through a stomach tubing throughout the experiment in the amount of 250mg per Kg body weight for aspirin or 50mg per Kg body weight for ibuprofen. The fractured femurs were taken out of the rats at the interval of 2, 3, 4 and 5 weeks after the fracture and subjected to histochemical examinations using Mallory azan staining method to observe collagen fibers in the area of bone union and Alcian blue staining method known to be specific for detecting mucopoly saccharides to observe formation and transformation of bone healing area. The results obtained were as follows;
1) In case of control group, process of tissue differentiation went like below. After 2 weeks loose connective tissue accompanied by thrombos was formed at both fracture ends except thin layer of cartilage. After 3 weeks, most of the connective tissue was replaced by cartilage. After 4 weeks, bone healing was partly observed. The area where bone healing did not occur was connected by cartilage. After 5 weeks, bone healing was completed in the form of cancellous bone. In case of aspirin-treated and ibuprofen-treated groups, loose connective tissue accompanied by thrombos still remained to be seen after 2 and 3 weeks. After 4 weeks, cartilage wider than that of control group was observed and bone healing did not take place yet. After 5 weeks, bone healing was incompletely finished and the area disributed with cartilage was still observed.
2) In control group, mucopolysaccharide of matrix in the fracture area of femoral shaft indicated acidic nature at 2, 3 and 4 weeks after the fracture, but after 5 weeks, it indicated acidic nature untill 4 weeks after the fracture. At 5th week, it indicated mixture of acidic and neutral nature. In ibuprofen-treated group, from 2nd week to 4th week, acidic nature had been indicated. At 5th week, acidic nature was indicated in carilage and neutral nature was indicated in bone-tissue.
With the resukts obtained in the present study, it can be concluded that a longterm treatment of non-steroidal anti-inflammatory drugs would cause delay in bonehealing following the fracture.