Investigation of the effects of "feniramidol" and "diclofenac" treatment on fracture healing in rats

Objective: Fracture healing or nonunion is a process in which many factors interact together. There are many treatment, physical and biological therapy methods that affect different steps of this process, as well as many biological and chemical agents that cause non-union or delayed union of the fracture. Nonsteroidal anti-inflammatory agents have been blamed as the cause of fracture nonunion in many previous studies. In this study, the radiological, histological and biomechanical effects of Feniramidol and Diclofenac, which are frequently used in the treatment of post-fracture pain in our country and in the world, on fracture healing or nonunion of the fracture were evaluated in a rat femur fracture model. Materials and Methods: In this study, 72 female Wistar-Albino rats aged 4.5 months and weighing 300±50 g were divided into 4 groups as pheniramidol group (group1a, group1b, group1c n:18), diclofenac group (group2a, group2b, group2c n:18), pheniramidol+diclofenac group (group3a, group3b, group3c n:18) and control group (group4a, group4b, group4c n:18). All groups were sacrificed at 15, 30 and 45 days and divided into 12 subgroups of 6 rats each for radiological, histopathological and biomechanical evaluation. Animals were kept in a cage with controlled temperature (23-25°C) and 12:12 hours light/dark cycle. Radiological evaluation was performed by Lane and Sandhu and histopathological scoring was performed by Hue et al. Biomechanical evaluation was performed using BESMAK BMT-E series material testing machine (Besmak, Ankara, Turkey) and the measurements (Newton) were compared. Results: Statistical analyses were performed with NCSS (Number Cruncher Statistical System) 2007 Statistical Software (Utah, USA) package programme. In our study, no statistically significant difference was observed between the 15th day, 30th day and 45th day Pathology Score values of the Control, Diclofenac, Feniramidol and Feniramidol+Diclofenac Groups (p=0.571, p=0.743, p=0.878). No statistically significant difference was observed between Day 15 and Day 30 Radiology Score values of Control, Diclofenac, Feniramidol and Feniramidol+Diclofenac Groups (p=0,227, p=0,055). A statistically significant difference was observed between Day 15 Biomechanical values of Control, Diclofenac, Feniramidol and Feniramidol+Diclofenac Groups (p=0,001). Conclusions: Pheniramidol, Diclofenac, Pheniramidol+Diclofenac treatment has no statistically negative or positive effect on the histological examination of fracture healing compared to the control group. Statistically significant Deciency was observed between the groups in terms of biomechanical and radiological aspects. The radiology results of the control group were found to be statistically higher. The biomechanical results of the diclofenac group were found to be statistically lower. Key Words: Fracture healing, Rat, Pheniramidol, Diclofenac, Pheniramidol+Diclofenac