Local injection of simvastatin for repair of mild-to-moderate unstable humeral fractures: effects on bone healing and bone density

doi:10.3969/j.issn.2095-4344.2015.37.006

Abstract

Abstract:

BACKGROUND: Studies have shown that a single injection of small-dose simvastatin can significantly improve bone microstructure and promote trabecular bone remodeling of the femoral condyle after osteoporosis.

OBJECTIVE: To investigate the effect of local single injection of simvastatin on the prognosis of mild-to-moderate unstable humeral fractures.

METHODS: A total of 93 patients with mild-to-moderate unstable humeral fracture were selected and randomized into injection group (49 cases) and normal group (44 cases). The normal group received normal physical therapy, and the injection group underwent local single injection of simvastatin based on the physical therapy. Bone mineral density and healing time were compared between two groups.

RESULTS AND CONCLUSION: There was no difference in the bone mineral density between the two groups within 2 weeks after treatment (P > 0.05), but the bone mineral density was significantly higher in the injection group than the normal group at 1-2 months after treatment (P < 0.05). In addition, the injection group was superior to the normal group in the following aspects: incidence of complications, excellent-good rate of joint function recovery, and hospital stay. These findings indicate that the local injection of simvastatin based on conventional physical therapy can shorten the time of fracture healing, increase bone mineral density and improve the prognosis of patients with mild-to-moderate unstable proximal humeral fractures.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Humerus, Fractures, Bone Density, Drug Therapy

CLC Number:

R318

Liu Jian, Tian Bao-fang, Wang Wen-zhu, Zheng Wei-dong, Feng Li, Du Bao-yin, Tian Da-wei. Local injection of simvastatin for repair of mild-to-moderate unstable humeral fractures: effects on bone healing and bone density[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(37): 5933-5937.

Figures/Tables 2

References

[1] 沈建业,谭志胜,郑彩平，等.微创治疗儿童肱骨髁上不稳定骨折[J].中华手外科杂志,2009,25(4):208-210.

[2] 刘贵政,李青元,郑坤，等.闭合复位经皮克氏针内固定治疗儿童不稳定肱骨髁上骨折37例[J].陕西医学杂志,2013,42(9): 1141-1143.

[3] 公茂琪,查晔军,李庭，等.肱骨髁间骨折术后不愈合的原因分析及治疗[J].中华创伤骨科杂志,2010,12(6):534-537.

[4] 许军.肱骨近端锁定钢板治疗肱骨近端骨折效果观察[J].国际医药卫生导报,2010,16(20):2502-2504.

[5] 许军,赵玉驰.LPHP治疗肱骨近端不稳定骨折26例分析[J].中国误诊学杂志,2010,10(28):7001.

[6] 习建华,何齐芳,边振宇.他汀类药物干预激素性股骨头坏死机制研究进展[J].浙江实用医学,2014,2(12):152-154.

[7] 彭兰,杜晓刚,范能全,等.Pdlim2在高脂血症大鼠肾小球足细胞中的表达改变及意义[J].中华肾脏病杂志,2014,30(3):217-221.

[8] 薛江义,张晶晶,卢向东,等.阿仑膦酸钠联合辛伐他汀对骨质疏松骨折的影响[J].中国医药科学,2014,10(4):20-23.

[9] 孙俊英,章秋.辛伐他汀对链脲佐菌素致2型糖尿病大鼠骨密度的影响[J].中国医师杂志,2014,6(13):798-799.

[10] 朱剑峰,朱红静,李志辉,等.辛伐他汀对绝经期冠心病合并骨质疏松患者骨密度的影响分析[J].中国生化药物杂志,2014,6(12): 158-159.

[11] 刘晓宁,彭风芹,孔德明,等.辛伐他汀对绝经伴血脂代谢异常女性跟骨骨密度的影响[J].中国骨质疏松杂志,2014,10(8): 1236-1239.

[12] 刘艳霞,黄岚,朱鲜阳,等.辛伐他汀对平滑肌祖细胞分化、增殖、迁移及黏附能力的影响[J].心血管康复医学杂志,2014,5(12): 519-522.

[13] 徐谦,曹柳,刘琼,等.2型糖尿病大鼠骨骼肌Toll样受体4的表达及辛伐他汀的干预作用[J].中华生物医学工程杂志,2014,20(1): 12-16.

[14] de Matos MB,Puga AM,Alvarez-Lorenzo C,et al.Osteogenic poly(ε-caprolactone)/poloxamine homogeneous blends prepared by supercritical foaming.Int J Pharm.2014;479(1): 11-22.

[15] Wang H, Liu J, Tao S, et al. Tetracycline-grafted PLGA nanoparticles as bone-targeting drug delivery system.Int J Nanomedicine.2015;8(10):5671-5685.

[16] Kwon YD, Yang DH, Lee DW. A Titanium Surface-Modified with Nano-Sized Hydroxyapatite and Simvastatin Enhances Bone Formtion and Osseintegration.J Biomed Nanotechnol. 2015;11(6):1007-1015.

[17] Oryan A, Kamali A, Moshiri A. Potential mechanisms and applications of statins on osteogenesis: Current modalities, conflicts and future directions.J Control Release.2015; 10(215):12-24.

[18] Chauhan AS, Maria A, Managutti A. Efficacy of Simvastatin in Bone Regeneration After Surgical Removal of Mandibular Third Molars: A Clinical Pilot Study.J Maxillofac Oral Surg. 2015;14(3):578-585.

[19] Tan J, Fu X, Sun CG, et al. A single CT-guided percutaneous intraosseous injection of thermosensitive simvastatin/poloxamer 407 hydrogel enhances vertebral bone formation in ovariectomized minipigs.Osteoporos Int.2015; 7(30)112-114.

[20] Soares EA, Novaes RD, Nakagaki WR, et al. Metabolic and structural bone disturbances induced by hyperlipidic diet in mice treated with simvastatin.Int J Exp Pathol. 2015;96(4): 261-268.

[21] Li XF, Lin CB, Xie FR, et al. Effects of Simvastatin and Combination of Simvastatin and Nylestriol on Bone Metabolism in Ovariectomized Rats.Am J Ther.2015;7(9): 112-114.

[22] Cannon CP, Blazing MA, Giugliano RP, et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes.N Engl J Med.2015;372(25):2387-2397.

[23] Vieira GM, Chaves SB, Ferreira VM, et al. The effect of simvastatin on relapse of tooth movement and bone mineral density in rats measured by a new method using microtomography.Acta Cir Bras.2015;30(5):319-327.

[24] Tan J, Yang N, Fu X, et al. Single-dose local simvastatin injection improves implant fixation via increased angiogenesis and bone formation in an ovariectomized rat model.Med Sci Monit.2015;18(21):1428-1439.

[25] Yan Q, Xiao LQ, Tan L, et al. Controlled release of simvastatin-loaded thermo-sensitive PLGA-PEG-PLGA hydrogel for bone tissue regeneration: in vitro and in vivo characteristics.J Biomed Mater Res A.2015;5(12):112-113.

[26] Fang W, Zhao S, He F, et al. Influence of simvastatin-loaded implants on osseointegration in an ovariectomized animal model.Biomed Res Int.2015;20(15):831504.

[27] Vu F, Guinand S, Pasche O, et al. 2014 literature findings in internal general medicine.Rev Med Suisse.2015;11(458): 174-176,

[28] Zhang HX, Xiao GY, Wang X, et al. Biocompatibility and osteogenesis of calcium phosphate composite scaffolds containing simvastatin-loaded PLGA microspheres for bone tissue engineering.J Biomed Mater Res A.2015;103(10): 3250-3258.

[29] Moshiri A, Shahrezaee M, Shekarchi B, et al. Three-Dimensional Porous Gelapin-Simvastatin Scaffolds Promoted Bone Defect Healing in Rabbits. Calcif Tissue Int.2015;96(6):552-564.

[30] Issa JP, Ingraci de Lucia C, Dos Santos Kotake BG, et al. The effect of simvastatin treatment on bone repair of femoral fracture in animal model.Growth Factors.2015;33(2):139-148.

[31] Kahraman OE, Erdogan Ö, Namli H, et al. Effects of local simvastatin on periosteal distraction osteogenesis in rabbits.Br J Oral Maxillofac Surg.2015;53(4):18-22.

[32] Koçer A, Öner M, Karaman ?, et al. The effects of locally applied simvastatin on an experimental mouse femur nonunion model.Acta Orthop Traumatol Turc.2014;48(6): 679-684.

[33] Sun Y, Yan LQ, Liang Y, et al. Reduction of epidural scar adhesion by topical application of simvastatin after laminectomy in rats.Eur Rev Med Pharmacol Sci.2015;19(1): 3-8.

[34] Li Y, Müller AL, Ngo MA, et al. Statins impair survival of primary human mesenchymal progenitor cells via mevalonate depletion, NF-κB signaling, and Bnip3.J Cardiovasc Transl Res.2015;8(2):96-105.

[35] de Matos MB, Puga AM, Alvarez-Lorenzo C, et al. Osteogenic poly(ε-caprolactone)/poloxamine homogeneous blends prepared by supercritical foaming.Int J Pharm.2015;479(1): 11-22.

[36] Holwegner C, Reinhardt AL, Schmid MJ, et al. Impact of local steroid or statin treatment of experimental temporomandibular joint arthritis on bone growth in young rats.Am J Orthod Dentofacial Orthop.2015;147(1):80-88.

[37] Thitiwuthikiat P, Ii M, Saito T, et al. A vascular patch prepared from Thai silk fibroin and gelatin hydrogel incorporating simvastatin-micelles to recruit endothelial progenitor cells. Tissue Eng Part A.2015;.21(7-8):1309-1319.

[38] Ferreira LB, Bradaschia-Correa V, Moreira MM, et al. Evaluation of bone repair of critical size defects treated with simvastatin-loaded poly(lactic-co-glycolic acid) microspheres in rat calvaria.J Biomater Appl.2015;29(7):965-976.

[39] Orellana BR, Puleo DA. Tailored sequential drug release from bilayered calcium sulfate composites.Mater Sci Eng C Mater Biol Appl.2014,43(10):243-252.

[40] Jiang J, Boyle LJ, Mikus CR, et al. The effects of improved metabolic risk factors on bone turnover markers after 12 weeks of simvastatin treatment with or without exercise. Metabolism.2014;63(11):1398-1408.