ReviewClinical orthopaedics and related research2010
Intramedullary nailing as a 'second hit' phenomenon in experimental research: lessons learned and future directions.
Review in Clinical orthopaedics and related research, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Caught in the Crossroads: Damage Control Orthopedics versus Early Total Care for Polytrauma in the Indian Scenario.Annals of African medicine · 2026Review
- Attenuating pulmonary injury and inflammation with C5/CD14 inhibition therapy: results from a porcine polytrauma model with blunt chest trauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Assessing Cardiopulmonary Safety of Intramedullary Bone Graft Harvesting: A Comparative Study of the RIA 2 System and the ARA Concept.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025Article
- In vivo study to assess fat embolism resulting from the Reamer-Irrigator-Aspirator 2 system compared to a novel aspirator-based concept for intramedullary bone graft harvesting.Archives of orthopaedic and trauma surgery · 2024Article
- Severely injured patients: modern management strategies.EFORT open reviews · 2023Review
- Effects of Exercise on COVID-19 Patients: A Narrative Review.Medical journal of the Islamic Republic of Iran · 2022Review
- Inflammatory and Coagulative Considerations for the Management of Orthopaedic Trauma Patients With COVID-19: A Review of the Current Evidence and Our Surgical Experience.Journal of orthopaedic trauma · 2020Review
- Complement Activation and Organ Damage After Trauma-Differential Immune Response Based on Surgical Treatment Strategy.Frontiers in immunology · 2020Article
- Double-plating fixation of comminuted femoral shaft fractures with concomitant thoracic trauma.The Journal of international medical research · 2018Article
- Damage control resuscitation: lessons learned.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2016Review
- The influence of the method of initial stabilization of traumatic femoral shaft fractures on postoperative morbidity and mortality - a retrospective study.Romanian journal of anaesthesia and intensive care · 2014Article
- Complement mediates a primed inflammatory response after traumatic lung injury.The journal of trauma and acute care surgery · 2014Article
- Increased Risk of Pulmonary Complications with Long Cephalomedullary Nails in Geriatric Intertrochanteric Femur Fractures: A Retrospective Review of 881 Patients.JB & JS open accessArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 'second hit' phenomenon is based on the fundamental concept that sequential insults, which are individually innocuous, can lead to overwhelming physiologic reactions. This response can be expressed in several organic systems and can be examined by measurement of several parameters. PURPOSES: The purpose of this study was to evaluate the incidence of systemic effects of intramedullary nailing and the role of concurrent head and thoracic injuries as they have been recorded in vivo. We also wanted to determine what would be the optimal animal model for future research and what variables should be investigated.
methodsWe reviewed the available literature of animal studies that used surgery, and particularly nailing, as a second hit. The reviewed studies were retrieved through an electronic search of the MEDLINE database. We analyzed the methods of creating the first and second hits (nailing), the characteristics of the animal models, the variables examined, and the pathophysiologic responses, which appeared after the second hit.
resultsSecond hit reamed intramedullary nailing was found to provoke consumption of coagulation factors, whereas the effect of unreamed nailing on coagulation factors appears inconsistent. Hemodynamic factors were affected only transiently by the second hit, whereas the pulmonary function was affected only when the first hit included lung injury.
conclusionsThoracic and head injuries predispose to an aggravated second hit. Primate animal models are considered to be closer to clinical reality and should be preferred for future studies. Future studies should include measurements of proinflammatory and antiinflammatory markers.
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