Gebhard J S, Johnston-Jones K, Kody M H, Kabo J M, Meals R A
Wadsworth VA Medical Center, Los Angeles, CA.
J Hand Surg Am. 1993 Nov;18(6):1080-5. doi: 10.1016/0363-5023(93)90406-S.
In an effort to blunt the inflammatory response following injury, we studied the effects of antihistamines on joint stiffness and bone healing after periarticular fracture. The hind limbs of 37 New Zealand white rabbits were instrumented with intramedullary Steinmann pins to allow immobilization after creating a distal tibia fracture. After periarticular ankle fracture, the rabbits were divided into groups to receive chlorpheniramine, low-dose terfenadine, high-dose terfenadine, or no antihistamine. Antihistamine was administered for the first 5 days after fracture. At 3 weeks after fracture, the rabbits treated with antihistamines showed a significant reduction in joint stiffness compared to control animals. To determine if antihistamine also retarded bone healing, an additional 12 New Zealand white rabbits underwent bilateral drilling of the midshaft of the femur with a 2.5 mm Steinmann pin. Six animals received oral terfenadine, and six served as controls. After 5 weeks of cage activity, the animals treated with the antihistamine showed a significant decrease in energy to failure of the femurs on torsional testing. Qualitative microscopic examination revealed less mature callus at the site of the femoral cortical defect in those animals treated with the terfenadine. Antihistamine may have heretofore unconsidered benefits in preventing post-traumatic joint stiffness but may slow healing of associated bony injuries.
为了减轻损伤后的炎症反应，我们研究了抗组胺药对关节周围骨折后关节僵硬和骨愈合的影响。对37只新西兰白兔的后肢插入髓内斯氏针，以便在造成胫骨远端骨折后进行固定。在关节周围踝关节骨折后，将兔子分成几组，分别给予氯苯那敏、低剂量特非那定、高剂量特非那定或不给予抗组胺药。骨折后的前5天给予抗组胺药。骨折后3周，与对照动物相比，接受抗组胺药治疗的兔子关节僵硬程度显著降低。为了确定抗组胺药是否也会延迟骨愈合，另外12只新西兰白兔用2.5毫米斯氏针对股骨中段进行双侧钻孔。6只动物口服特非那定，6只作为对照。在笼养活动5周后，接受抗组胺药治疗的动物在扭转试验中股骨断裂能量显著降低。定性显微镜检查显示，用特非那定治疗的动物股骨皮质缺损部位的骨痂成熟度较低。抗组胺药在预防创伤后关节僵硬方面可能有此前未被考虑到的益处，但可能会延缓相关骨损伤的愈合。
