Effect of diclofenac sodium on union of tibial fractures in rats

Abstract

Nonsteroidal anti-inflammatory drugs are often used for 7 to 10 days after fracture because of their effects on bone metabolism. This study evaluated the effect of diclofenac sodium, administered at clinical dosage and duration, on bone union. Fifty-four male Wistar rats were randomly and equally divided into three groups: control, diclofenac 1 mg, and diclofenac 2 mg. Closed diaphyseal fractures were induced in the right tibias of all rats; the two diclofenac groups received intramuscular injections in the contralateral hips for 10 days. All animals were immobilized in circular casts on the upper thighs. Six rats in each group were sacrificed at weeks 2, 4, and 6, and bony union was evaluated clinically, radiologically, and histologically. At the end of 2 weeks, clinical examinations showed subjective differences between the two treated groups and control animals, with more stable callus formation in controls. Radiologic evaluation of the callus showed numeric, but not significant, differences between control and treated animals. At 4 and 6 weeks, clinical and radiologic findings were comparable among groups. Histologically, no significant differences in callus formation were evident at any evaluation.

Effect of Non-Steroidal Anti-Inflammatory Drugs on Bone Healing

“…Most studies using osteotomy and bone ingrowth models have demonstrated that indomethacin and ibuprofen treatment retards bone healing [29,33,34,35,36,37,38,48,53,54]. In contrast, only a few studies indicate that NSAIDs have little or no effect on fracture healing outcomes [55,56,57,58,59,60]. One study concluded that indomethacin treatment had no effect on cortical bone healing following a small drill hole defect (2 mm in diameter) [61].…”

Prostaglandins and bone: potential risks and benefits related to the use of nonsteroidal anti-inflammatory drugs in clinical dentistry

“…Considerable experimental evidence has indicated that conventional non-selective NSAIDs (indomethacin, ibuprofen, naproxen, ketorolac) have inhibitory effects on long bone fracture healing (2,3,13) although an absence of this deleterious effect has also been reported (27)(28)(29)(30). It has been suggested that factors such as dosage and duration of treatment could affect the results, as well as intra-and inter-species differences regarding sensitivity to drugs, compensatory local and systemic factors, rate of bone remodeling and pharmacokinetics of drugs in laboratory animals compared to humans (3,29).…”

Effects of cyclooxygenase inhibition on bone, tendon, and ligament healing

“…In contrast, other studies suggest that NSAIDs have no signifi cant effect on bone repair or that their effects can only partially be attributed to the inhibition of PG synthesis [89,92,[96][97][98][99][100]. For example, no effects on collagen synthesis, an important marker of bone healing, were observed in vitro in rat fracture callus [101].…”