RESEARCH ARTICLE


The Effect of Low Molecular Weight Heparins on Fracture Healing



Stylianos Kapetanakis*, 1, Evangelos Nastoulis 1, Theano Demesticha 2, Thespis Demetriou 1
1 Department of Anatomy, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
2 Department of Anatomy, Medical School, Faculty of Medicine Sciences, National and Kapodistrian University of Athens, Athens, Greece


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© Kapetanakis et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Anatomy, Medical School, Democritus University of Thrace, Dragana Medical School of Alexandroupolis, Alexandroupolis 68100, Greece; Tel: +306972707384; Fax: +302541067200; E-mail: stkapetanakis@yahoo.gr


Abstract

Venous Thromboembolism is a serious complication in the trauma patient. The most commonly studied and used anticoagulant treatment in prophylaxis of thrombosis is heparin. The prolonged use of unfractionated heparin has been connected with increased incidence of osteoporotic fractures. Low molecular-weight-heparins (LMWHs) have been the golden rule in antithrombotic therapy during the previous two decades as a way to overcome the major drawbacks of unfractioned heparin. However there are few studies reporting the effects of LMWHs on bone repair after fractures. This review presents the studies about the effects of LMWHs on bone biology (bone cells and bone metabolism) and underlying the mechanisms by which LMWHs may impair fracture healing process. The authors’ research based on literature concluded that there are no facts and statistics for the role of LMWHs on fracture healing process in humans and the main body of evidence of their role comes from in vitro and animal studies. Further large clinical studies designed to compare different types of LMWHs, in different dosages and in different patient or animal models are needed for exploring the effects of LMWHs on fracture healing process.

Keywords: Fracture healing, fractures, heparin, low molecular weight heparin.