Objective: Long-term exposure to antiepileptics causes adverse effects on bone metabolism, but the available English literature regarding fracture healing is limited. In his study, We compare the effects of carbamazepine and levetiracetam on fracture healing.

Material and Method: Thirty Sprague-Dawley rats were randomly assigned to three groups of ten. Carbamazepine and levetiracetam were administered to rats in the first (CAR) and second group (LEV), respectively; the third group (CONT) served as the control group. Drug administration was started four weeks before fracture model establishment. Then a closed fracture was created and fixed. In each group, half of the rats were sacrificed at 4 weeks and then at 6 weeks. All femurs were evaluated with plain radiography using radiographic union scale in tibial (RUST) fractures scoring, Lane & Sandhu scoring.

Besides microtomography (micro-CT), and histological Huo scoring was performed.

Results: Radiological scores were superior in all groups in the sixth week than in the fourth week (p<0.01). The group with the lowest bone mineral density (BMD) was the CAR group, followed by the LEV group in the 4th and 6th weeks (p<0.01). The callus mineralization rate was lower in the drug groups in the 4th week (p=0.05). There was no significant difference between the groups at 6 weeks in micro-CT analysis (p=0.54). Histologic scores were similar to micro-CT in the 4th week, but the carbamazepine group had the lowest scores in the 6th week (p<0.01).

Conclusion: This study demonstrated that carbamazepine and levetiracetam adversely affect the early period of fracture healing.

Carbamazepine Levetiracetam Fracture healing Microtomography