C-reactive protein levels for early detection of early postoperative complications after proximal femoral fracture surgery

Schutz, Romain; Boukebous, Baptiste; Boutroux, Pierre; Guillon, P.

doi:10.1007/s00590-017-2080-z

Cited by 8 publications

(7 citation statements)

References 18 publications

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“…Their 42 patients included hip arthroplasties as well as osteosynthetic treatments. The inclusion of osteosyntheses could have possibly influenced their analysis, while their overall number of patients was lower than ours [49]. Klim et al similarly investigated the predictive value of CRP kinetics in the detection of a PJI in total hip or knee arthroplasties.…”

Section: Discussionmentioning

confidence: 79%

“…In comparison to our study the authors examined a higher number of patients with infection. Schutz et al [49] achieved a sensitivity of 65% and a specificity of 85% with two CRP values above their correlation, which was calculated with the help of a linear mixed model. Their 42 patients included hip arthroplasties as well as osteosynthetic treatments.…”

Section: Discussionmentioning

confidence: 99%

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Predicting the Exception—CRP and Primary Hip Arthroplasty

Meier

Bauer

Maheshwari

et al. 2021

JCM

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Background: While primary hip arthroplasty is the most common operative procedure in orthopedic surgery, a periprosthetic joint infection is its most severe complication. Early detection and prediction are crucial. In this study, we aimed to determine the value of postoperative C-reactive protein (CRP) and develop a formula to predict this rare, but devastating complication. Methods: We retrospectively evaluated 708 patients with primary hip arthroplasty. CRP, white blood cell count (WBC), and several patient characteristics were assessed for 20 days following the operative procedure. Results: Eight patients suffered an early acute periprosthetic infection. The maximum CRP predicted an infection with a sensitivity and specificity of 75% and 56.9%, respectively, while a binary logistic regression reached values of 75% and 80%. A multinominal logistic regression, however, was able to predict an early infection with a sensitivity and specificity of 87.5% and 78.9%. With a one-phase decay, 71.6% of the postoperative CRP-variance could be predicted. Conclusion: To predict early acute periprosthetic joint infection after primary hip arthroplasty, a multinominal logistic regression is the most promising approach. Including five parameters, an early infection can be predicted on day 5 after the operative procedure with 87.5% sensitivity, while it can be excluded with 78.9% specificity.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Predicting the Exception—CRP and Primary Hip Arthroplasty

Meier

Bauer

Maheshwari

et al. 2021

JCM

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“…Kinoshita et al utilized Hgb and C-reactive protein (CRP) levels to track the post-operative course of a patient who developed a profunda femoris artery pseudoaneurysm after internal fixation of a trochanteric fracture [8] . While rising CRP levels are used to detect early signs of post-operative infections, Kinoshita et al observed rising CRP levels with the development of their patient's anemia in the absence of infection, which all normalized after blood transfusions and embolization [8] , [10] . Notably, our patient experienced significant intra-operative bleeding for a short period during surgery, but it was the hemodynamic decompensation and precipitous drop in Hgb post-operatively that prompted further workup.…”

Section: Discussionmentioning

confidence: 99%

Medial femoral circumflex artery pseudoaneurysm following intramedullary nailing for intertrochanteric fracture

Nguyen

Only

Onizuka

et al. 2022

Trauma Case Reports

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Case We present the case of a 92-year-old woman who developed a medial femoral circumflex artery (MFCA) pseudoaneurysm intraoperatively while obtaining reduction during intramedullary nailing (IMN) for intertrochanteric fracture. Conclusions Pseudoaneurysms are rare vascular complications in hip fracture surgery. Early recognition of signs and symptoms of this phenomenon are essential for diagnosis and treatment. Close post-operative monitoring and serial hemoglobin should be considered for unexplained intra-operative bleeding. A low threshold for angiography should be entertained if active bleeding and clinical decompensation occur during instrumented percutaneous pertrochanteric fracture reduction. This patient underwent conventional angiography with successful coil embolization and exclusion of the MFCA pseudoaneurysm.

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“…In the current study, rising CRP levels were also observed with the progression of anemia without signs of infection of the surgical wounds or other organs. CRP levels for early detection are said to correlate with early postoperative complications such as infection, dislocation, and hematoma after proximal femoral fracture surgery [ 11 ]. It should be noted that not only infection can develop but also vascular injury, swelling of the affected limb, decreased Hb levels, and elevated CRP levels in the early postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Huge Pseudoaneurysm of the Femoral Artery after Internal Fixation of Femoral Trochanteric Fracture

Kinoshita

Hashimoto²,

Hirayama³

et al. 2018

Case Reports in Orthopedics

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Pseudoaneurysm is one of the most serious complications of femoral trochanteric fracture surgery. Since the rupture of pseudoaneurysm may lead to death, early detection is important. We report the case of an 80-year-old male who developed pain in the proximal thigh and severe swelling after internal fixation of a femoral trochanteric fracture with a hip nail. Angiography revealed a pseudoaneurysm of a branch of the deep femoral artery near the interlocking screw. The vascular lesion was immediately treated by transcatheter embolization, and the vascular leakage was completely resolved with catheter embolization. After embolization, the patient's clinical state improved rapidly, and the laboratory values improved to normal after several weeks. The current case study reminds us that pseudoaneurysm can occur after intramedullary nail placement to treat a femoral trochanteric fracture.

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C-reactive protein levels for early detection of early postoperative complications after proximal femoral fracture surgery

Abstract: Prospective observational study.

Cited by 8 publications

References 18 publications

Predicting the Exception—CRP and Primary Hip Arthroplasty

Predicting the Exception—CRP and Primary Hip Arthroplasty

Medial femoral circumflex artery pseudoaneurysm following intramedullary nailing for intertrochanteric fracture

Huge Pseudoaneurysm of the Femoral Artery after Internal Fixation of Femoral Trochanteric Fracture

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