Impact of the Method of Initial Stabilization for Femoral Shaft Fractures in Patients With Multiple Injuries at Risk for Complications (Borderline Patients)

Pape, Hans-Christian; Rixen, Dieter; Morley, John; Husebye, Elisabeth Ellingsen; Mueller, Michael; Dumont, C.; Grüner, A.; Oestern, Hans Joerg; Bayeff-Filoff, M; Garving, Christina; Pardini, Dustin A.; Griensven, Martijn van; Krettek, Christian; Giannoudis, Peter V.

doi:10.1097/sla.0b013e3181485750

Cited by 246 publications

(137 citation statements)

References 63 publications

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“…Recently, an increasing research interest has been focused on the issue of cytokines and their role in immune activity in trauma patients [1][2][3][4][5]. Skeletal and tissue injuries may cause a hyper-inflammatory reaction of the immune system manifested by elevation in levels of pro-inflammatory cytokines and may lead to the development of systemic inflammatory reaction syndrome (SIRS).…”

Section: Introductionmentioning

confidence: 99%

Cytokine Levels (IL-4, IL-6, IL-8 and TGFβ) as Potential Biomarkers of Systemic Inflammatory Response in Trauma Patients

Volpin

Cohen

Assaf

et al. 2014

International Orthopaedics (SICOT)

108

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Purpose Much research is now being conducted in order to understand the role of cytokines in the development of the inflammatory response following trauma. The purpose of this study was to evaluate whether serum levels of certain cytokines, measured immediately after initial injury, can be used as potential biomarkers for predicting the development and the degree of severity of the systemic inflammatory response (SIRS) in patients with moderate and severe trauma. Methods We conducted a prospective study with 71 individuals of whom 13 (18.3 %) were healthy controls and 58 (81.7 %) were traumatized orthopaedic patients who were categorized into two groups: 31 (43.6 %) with moderate injuries and 27 (38.1 %) patients with severe orthopaedic trauma. Thirty cc of heparinized blood were drawn from each individual within a few hours after the injury. Serum levels of pro-inflammatory, regulatory and anti-inflammatory cytokines were measured in each individual participant.

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Section: Introductionmentioning

confidence: 99%

Cytokine Levels (IL-4, IL-6, IL-8 and TGFβ) as Potential Biomarkers of Systemic Inflammatory Response in Trauma Patients

Volpin

Cohen

Assaf

et al. 2014

International Orthopaedics (SICOT)

108

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“…and temporary stabilization of big bone fractures (such as femur) by external fixation devices. If the patient's condition is stabilizing, a secondary definitive procedure of osteosynthesis is performed (after 5 days) [8,12,13]. This tactic has reliably improved the results of treatment of severely injured patients with polytrauma and helps to save the lives of numerous trauma victims.…”

Section: Discussionmentioning

confidence: 99%

Choice of Optimal Time and Type of Orthopedic Surgery in Multiple Injured Patients with Acute Respiratory Distress Syndrome (ARDS) Depending on Age: Retrospective Study

Stanislavovych¹,

Vasylivna²

2013

Ortop Traumatol Rehabil

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SUMMARYBackground. Multiple traumatic injuries are severe conditions with a high risk of complications. He morrhage, multiple organ failure syndrome (MOFS), systemic inflammatory response syndrome (SIRS) and sepsis are the most dangerous sequelae. ARDS (acute respiratory distress syndrome) is a part of MOFS. Despite new strategies of prevention and care, the mortality associated with these conditions still remains high.Materials and methods. We conducted a retrospective study of the surgical management tactic of 145 patients with multiple trauma complicated by ARDS. All patients were treated in Ivano-Frankivsk Regional Clinical Hospital between 2007 and 2012. There were 118 (81.4%) males and 27 (18.6%) females. Patients were divided into two age groups. Group I consisted of 113 (78%) patients aged 18-64 years, including 106 (94%) males and 7 (6%) females. Group II consisted of 32 (22%) patients over 65 years old, with 7 (21.8%) males and 25 (78.2%) females. AISS-NISS (Abbreviated Injury Severity Score -New Injury Severity Score) scores were 55.9±1.312 in Group I and 54.9±2.43 in Group II.Results. The difference in emergency surgery timing between Group І and ІІ was not significant (р>0.05). Age was an important criterion in defining optimal time of osteosynthesis (р<0.01). The choice of osteosynthesis type did not depend on patient age in the early period of trauma (1-3 days) (р>0.05), but the surgical tactic was significantly different in the late period (8 days and more) (р<0.01). Active fracture management with a stable osteosynthesis technique (intramedullary nailing, plating and external fixation) was preferred in the younger age group.Conclusions. 1. The age of the patient is quite an important factor defining the surgical tactic. 2. However, neither age nor severity of injury to the anatomical segments is a reliable criterion for assessing the severity of a patient's condition.

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“…For trauma patients with severe concomitant injuries, early definitive repair is associated with higher morbidity. 13 Thus, delayed definitive repair of midshaft femur fractures may be the best approach in these patients. According to a large retrospective study, surgical repair delayed beyond twelve hours may reduce mortality by as much as 50 percent in severely injured patients.…”

mentioning

confidence: 99%

Management of comminuted fractures of the shaft of femur by interlocking nailing at a tertiary level hospital in India

et al. 2016

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Impact of the Method of Initial Stabilization for Femoral Shaft Fractures in Patients With Multiple Injuries at Risk for Complications (Borderline Patients)

Cited by 246 publications

References 63 publications

Cytokine Levels (IL-4, IL-6, IL-8 and TGFβ) as Potential Biomarkers of Systemic Inflammatory Response in Trauma Patients

Cytokine Levels (IL-4, IL-6, IL-8 and TGFβ) as Potential Biomarkers of Systemic Inflammatory Response in Trauma Patients

Choice of Optimal Time and Type of Orthopedic Surgery in Multiple Injured Patients with Acute Respiratory Distress Syndrome (ARDS) Depending on Age: Retrospective Study

Management of comminuted fractures of the shaft of femur by interlocking nailing at a tertiary level hospital in India

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