Melatonin ve kafeik asit fenetil ester’in iskemik şartlarda kırık iyileşmesi üzerine etkisi: Deneysel çalışma

Abstract

Amaç:Çalışmada melatonin ve kafeik asit fenetil ester (CAPE) antioksidan moleküllerinin iskemik ortamda kırık iyileşmesi üzerine etkisinin incelenmesi amaçlandı.

Çalışma planı: Kırk dört erkek Wistar-albino sıçan tibiasında kırık oluşturulup intramedüller pinleme ile tespit uygulandı. Daha sonra sıçanlar rastgele kırık, kırık-iskemi, kırık-iskemi-melatonin ve kırık-iskemi-CAPE gruplarına ayrıldı. İskemi gruplarındaki sıçanların femoral arterleri 4.5 saat süreyle klemplendi. Cerrahi girişimden 6 hafta sonra sıçanlar sakrifiye edildi ve radyografik, histolojik ve biyomekanik değerlendirmeler yapıldı.

Bulgular: Radyografik ve histolojik olarak, 6. hafta sonunda kırık-iskemi-CAPE grubu kırık-iskemi grubundan anlamlı olarak iyi sonuçlar verdi. Tüm gruplarda, tüm kırıkların radyolojik ve histolojik olarak tam iyileştiği saptandı. Maksimum kırılma kuvvetlerinin (N) karşılaştırılmasında, gruplar arasında (kırık-iskemi<kırık-iskemi-melatonin<kırık<kırık-iskemi-CAPE) anlamlı fark bulundu (p<0.005). Sertlik dereceleri (N/mm) açısından kırık ve kırık-iskemi-CAPE grupları arasında anlamlı fark bulunmazken, diğer tüm gruplar arasındaki fark anlamlıydı. Kırık, kırık-iskemi-melatonin ve kırık-iskemi-CAPE gruplarındaki sertlik dereceleri, kırık-iskemi grubundan anlamlı olarak daha yüksek bulundu (p<0.001).

Çıkarımlar: Vasküler yaralanma veya kompartman sendromu ile komplike hale gelmiş tibia kırıklarında, iskeminin kırık iyileşmesi üzerine olan muhtemel olumsuz etkileri, melatonin ve CAPE ile ortadan kaldırılabilir.

Keywords

• İskemi; kırık; kafeik asit fenetil ester; serbest oksijen radikalleri

The effects of melatonin and caffeic acid phenethyl ester (CAPE) on fracture healing under ischemic conditions

Abstract

Objective:The aim of this study was to investigate the effects of antioxidant molecules Melatonin and Caffeic Acid Phenethyl Ester (CAPE) on fracture healing under ischemic conditions.

Methods: A right tibia fracture was created and fixed with an intramedullary pin in forty four male Wistar-albino rats. The rats were then randomly allocated to fracture, fracture-ischemia, fracture- ischemia-melatonin, and fracture-ischemia-CAPE groups. Ischemia was created by clamping femoral arteries four and a half hours. Animals were killed and radiographic, histological and biomechanical evaluation was performed sixth week after surgery.

Results: The radiological and histological scores of the fracture-ischemia-CAPE group were significantly better than the fracture- ischemia group at 6th week follow-up. Complete radiographical and histological healing of all fractures was detected in all groups. There was a significant difference between the maximum fracture force between the groups (fracture-ischemia<fracture-ischemia-melatonin<fracture<fracture-ischemia-CAPE) (p<0.005). Although difference was not statistically significant between fracture and fracture-ischemia-CAPE groups, all other groups revealed statistically significant difference with respect to toughness (N/mm). Fracture-ischemia group revealed the lowest toughness.

Conclusion: Ischemia adversely affects the fracture healing of rat tibias. Melatonin and CAPE eradicate adverse effects of ischemia. Possible adverse effects of ischemia on fracture healing can be eradicated with melatonin and CAPE in patients with tibia fractures associated with vascular injury or compartment syndrome.

Keywords

• Ischemia
• fracture
• melatonin
• caffeic acid phenethyl ester
• free oxygen radicals

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