Cumulative Effects of Bone and Soft Tissue Injury on Systemic Inflammation: A Pilot Study

Pfeifer, Roman; Darwiche, Sophie S.; Kohut, Lauryn; Billiar, Timothy R.; Pape, Hans-Christian

doi:10.1007/s11999-013-2908-8

Cited by 26 publications

(23 citation statements)

References 32 publications

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“…As a biomedical explanation of the influence of fracture instability on mortality, we favor the preliminary evidence linking bone fracture fragments and consequent soft tissue injury to the initiation of a systemic inflammatory process likely related to pro-and anti- inflammatory cytokine responses at the time of injury. 20 There are adverse consequences of systemic inflammation in older immunocompromised or respiratory compromised patients. Furthermore, Vester et al 21 also report that the inflammatory response may also be dysregulated in older patients with hip fracture when compared with younger patients with long bone fracture.…”

Section: Discussionmentioning

confidence: 99%

Influence of Fracture Stability on Early Patient Mortality and Reoperation After Pertrochanteric and Intertrochanteric Hip Fractures

Chehade

Carbone²,

Awward

et al. 2015

Journal of Orthopaedic Trauma

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Section: Discussionmentioning

confidence: 99%

Influence of Fracture Stability on Early Patient Mortality and Reoperation After Pertrochanteric and Intertrochanteric Hip Fractures

Chehade

Carbone²,

Awward

et al. 2015

Journal of Orthopaedic Trauma

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“…Several studies have also shown that after resuscitation the local microcirculation disturbance appears to last for a longer period . This might be due to the post‐traumatic local and systemic increase of inflammation mediators, such as IL‐6 (Interleukin), IL‐8, IL‐10, HMGB 1 (High mobility group box 1) and TNF‐a (tumor necrosis factor alpha) . These mediators may affect the local perfusion by influencing the tone of the vessels and metabolism of the local tissue .…”

Section: Discussionmentioning

confidence: 99%

Analysis of skeletal muscle microcirculation in a porcine polytrauma model with haemorrhagic shock

Qiao

Horst

Teuben

et al. 2018

Journal Orthopaedic Research

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Polytraumatised patients with haemorrhagic shock are prone to develop systemic complications, such as SIRS (systemic inflammatory response syndrome), ARDS (acute respiratory distress syndrome) and MOF (multiple organ failure). The pathomechanism of severe complications following trauma is multifactorial, and it is believed that microcirculatory dysfunction plays an important role. The aim of this study was to determine the changes in the microcirculation in musculature over time during shock and subsequent resuscitation in a porcine model of haemorrhagic shock and polytrauma. Twelve pigs (German Landrace) underwent femur fracture, liver laceration, blunt chest trauma, and haemorrhagic shock under standard anaesthesia and intensive care monitoring. Microcirculation data were measured from the vastus lateralis muscle using a combined white light spectrometry and laser spectroscopy system every 15 min during the shock and resuscitation period, and at 24, 48, and 72 h. Oxygen delivery and oxygen consumption were calculated and compared to baseline. The relative haemoglobin, local oxygen consumption, and saturation values in the microcirculation were observed significantly lower during shock, however, no changes in the microcirculatory blood flow and microcirculatory oxygen delivery were observed. After resuscitation, the microcirculatory blood flow and relative haemoglobin increased and remained elevated during the whole observation period (72 h). In this study, we observed changes in microcirculation during the trauma and shock phases. Furthermore, we also measured persistent dysfunction of the microcirculation over the observation period of 3 days after resuscitation and haemorrhagic shock. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1377-1382, 2018.

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“…Traumatic injuries initiate a systemic inflammatory response that can lead to tissue adaptation at sites not directly affected by the initial injury (11,12) . In bone, it is well established that the bone formation and bone resorption rates near a fracture are higher than baseline activity; this is known as regional acceleratory phenomenon (RAP) (13)(14)(15) .…”

Section: Introductionmentioning

confidence: 99%

Age dependence of systemic bone loss and recovery following femur fracture in mice

Emami

Toupadakis

Telek

et al. 2018

Preprint

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The most reliable predictor of future fracture risk is a previous fracture of any kind. The etiology of this increased fracture risk is not fully known, but it is possible that fracture initiates systemic bone loss leading to greater fracture risk at all skeletal sites. In this study we investigated systemic bone loss and recovery following femoral fracture in young (3 month old) and middleaged (12 month old) mice. Transverse femur fractures were created using a controlled impact, and whole-body bone mineral density (BMD), trabecular and cortical microstructure, bone mechanical properties, bone formation and resorption rates, mouse voluntary movement, and systemic inflammation were quantified at multiple time points post-fracture. We found that fracture led to decreased whole-body BMD in both young and middle-aged mice 2 weeks postfracture; this bone loss was recovered by 6 weeks in young, but not middle-aged mice. Similarly, trabecular bone volume fraction (BV/TV) of the L5 vertebral body was significantly reduced in fractured mice relative to control mice 2 weeks post-fracture (-11% for young mice, -18% for middle-aged mice); this bone loss was fully recovered by 6 weeks post-fracture in young mice.At 3 days post-fracture we observed significant increases in serum levels of interleukin-6 and significant decreases in voluntary movement in fractured mice compared to control mice, with considerably greater changes in middle-aged mice than in young mice. At this time point we also observed increased osteoclast number on L5 vertebral body trabecular bone of fractured mice compared to control mice. These data show that systemic bone loss occurs after fracture in both young and middle-aged mice, and recovery from this bone loss may vary with age. This systemic response could contribute to increased future fracture risk following fracture, and these data may inform clinical treatment of fractures with respect to improving long-term skeletal health.

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Cumulative Effects of Bone and Soft Tissue Injury on Systemic Inflammation: A Pilot Study

Cited by 26 publications

References 32 publications

Influence of Fracture Stability on Early Patient Mortality and Reoperation After Pertrochanteric and Intertrochanteric Hip Fractures

Influence of Fracture Stability on Early Patient Mortality and Reoperation After Pertrochanteric and Intertrochanteric Hip Fractures

Analysis of skeletal muscle microcirculation in a porcine polytrauma model with haemorrhagic shock

Age dependence of systemic bone loss and recovery following femur fracture in mice

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