Çevik Hüseyin Bilgehan, Eceviz Engin, Çilingir Kaya Özlem Tuğçe, Ercan Feriha, Çeçen Gültekin Sıtkı
Department of Orthopaedics and Traumatology, University of Health Sciences, Kartal Dr. Lütfi Kırdar Research and Training Hospital, İstanbul, Turkey.
Department of Histology and Embryology, Marmara University, School of Medicine, İstanbul, Turkey.
Acta Orthop Traumatol Turc. 2020 Mar;54(2):207-212. doi: 10.5152/j.aott.2020.02.44.
The aim of the present study was to determine the effect of topical and systemic tranexamic acid (TXA) on fracture healing in a rat surgical model.
We created standard, right-sided, open, diaphyseal femoral fractures with intramedullary Kirschner wire fixation in 48 male rats and divided them into three groups: a topical TXA (10 mg/kg) group, a systemic TXA (10 mg/kg) group, and a control group. Fracture healing was evaluated radiographically and histologically after early (week 2) and late (week 4) postoperative sacrifice.
The radiological scores differed significantly among the all groups (p=0.001), as did the week 2 and 4 scores (p=0.003 and p=0.010, respectively). Radiologically, the topical TXA group exhibited better bone healing at both 2 (p=0.001) and 4 (p=0.007) weeks than the control group, and the systemic group showed better healing at both 2 (p=0.027) and 4 (p=0.023) weeks than the control TXA group. Moreover, bone healing was better in the group treated with topical rather than systemic TXA on radiological examinations performed at 2 (p=0.001) and 4 (p=0.007) weeks postoperatively (p=0.001 and p=0.007, respectively). Histologically, the groups differed significantly (p=0.001). The histological scores differed significantly among the all groups (p=0.001). At 2 weeks, the topical TXA group exhibited significantly better bone healing than the control group (p=0.001).
Our results suggested that topical application of TXA in fracture patients may accelerate healing, whereas systemic administration may adversely affect healing.
本研究旨在确定局部和全身应用氨甲环酸（TXA）对大鼠手术模型骨折愈合的影响。
我们在48只雄性大鼠中制造标准的右侧开放性股骨干骨折，并用髓内克氏针固定，将它们分为三组：局部TXA（10mg/kg）组、全身TXA（10mg/kg）组和对照组。在术后早期（第2周）和晚期（第4周）处死动物后，通过影像学和组织学方法评估骨折愈合情况。
所有组之间的放射学评分差异显著（p = 0.001），第2周和第4周的评分差异也显著（分别为p = 0.003和p = 0.010）。放射学检查显示，局部TXA组在第2周（p = 0.001）和第4周（p = 0.007）时的骨愈合情况均优于对照组，全身TXA组在第2周（p = 0.027）和第4周（p = 0.023）时的愈合情况均优于对照TXA组。此外，在术后第2周（p = 0.001）和第4周（p = 0.007）进行的放射学检查中，局部应用TXA组的骨愈合情况优于全身应用TXA组（分别为p = 0.001和p = 0.007）。组织学检查显示，各组之间差异显著（p = 0.001）。所有组的组织学评分差异显著（p = 0.001）。在第2周时，局部TXA组的骨愈合情况明显优于对照组（p = 0.001）。
我们的结果表明，在骨折患者中局部应用TXA可能会加速愈合，而全身给药可能会对愈合产生不利影响。
