The effect of various types low molecular weight heparins on fracture healing

Thromboembolic complications are the most common preventable cause of mortality and morbidity in trauma and arthroplasty patients. Therefore, this group of patients receive a prophylaxis for thromboemboli by mechanical or pharmacological methods. This study was designed to evaluate the effect of enoxaparin, nadroparin, dalteparin and fondaparinux on fracture healing in an experimental rat femur fracture model.

Thirty male, Wistar-Albino rats were divided randomly into five groups. A retrograde intramedullary kirschner wire was inserted under general anesthesia and then standard closed femoral shaft fractures were produced. After the production of fractures, treatment groups received enoxaparin, nadroparin, dalteparin and fondaparinux via subcutaneous injections and the control group received placebo injections for four weeks. The formation and healing of the bones were determined by clinical manual evaluation, radiographic and histopathological analyses.

Histological callus formation scores were found to be significantly increased in the fondaparinux group when compared to the control group at the end of the fourth week. Other treatment groups' histological scores did not show any significant difference with the control group. The histological scores of all groups were compared and the fondaparinux group histological score was found to be significantly increased. The clinical and radiological scores between the groups did not show any significant difference.

A positive histological effect of fondaparinux on fracture healing was observed in this study. This enhancing effect of fondaparinux may be related to its synthetic and selective composition and non-inhibitory effects on osteoblasts and growth factors.