ArticleWorld journal of emergency surgery : WJES2011
Intramedullary nailing of the femur and the systemic activation of monocytes and neutrophils.
Article in World journal of emergency surgery : WJES, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Neutrophil cell surface receptor dynamics following trauma: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Femoral nailing associated with bone marrow emboli in pigs induced a specific increase in blood IL-6 and broad inflammatory responses in the heart and lungs.Frontiers in immunology · 2024Article
- Independent predictors of systemic inflammatory response syndrome for intramedullary nailing of femoral shaft fractures: Analysis of national inpatient sample database.Journal of orthopaedics · 2023Article
- Standardized porcine unilateral femoral nailing is associated with changes in PMN activation status, rather than aberrant systemic PMN prevalence.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Longitudinal assessment of the inflammatory response: The next step in personalized medicine after severe trauma.Frontiers in medicine · 2022Review
- Shift of Neutrophils From Blood to Bone Marrow Upon Extensive Experimental Trauma Surgery.Frontiers in immunology · 2022Article
- Fracture fixation strategy and specific muscle tissue availability of neutrophilic granulocytes following mono- and polytrauma: intramedullary nailing vs. external fixation of femoral fractures.European journal of medical research · 2020Article
- Associated thoracic injury in patients with a clavicle fracture: a retrospective analysis of 1461 polytrauma patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2019Article
- Neutrophil heterogeneity and its role in infectious complications after severe trauma.World journal of emergency surgery : WJES · 2019Review
- Acute coagulofibrinolytic and inflammatory changes in response to intramedullary nailing and its impact on outcome.Journal of clinical orthopaedics and trauma · 2018Article
- Comparative investigation of percutaneous plating and intramedullary nailing effects on IL-6 production in patients with tibia shaft fracture.Acta orthopaedica et traumatologica turcica · 2017Article
- Fracture initiates systemic inflammatory response syndrome through recruiting polymorphonuclear leucocytes.Immunologic research · 2016Article
- Impact of monocytic cytokines in polytrauma patients with orthopedics injures.Journal of clinical orthopaedics and traumaArticle
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTrauma such as found patients with femur fractures, induces a systemic inflammatory response, which ranges from mild SIRS to ARDS. Neutrophils (i.e. PMN) play an important role in the pathogenesis of this inflammatory condition. Additional activation of PMNs during intramedullary nailing (IMN) is thought to act as a second immunological hit. Damage control orthopedics has been developed to limit this putative exacerbation of the inflammatory response. The hypothesis is tested that IMN exacerbates systemic inflammation, thereby increasing the risk for ARDS.
methodsThirty-eight trauma patients who required IMN for femur fracture were included. The development of SIRS and ARDS was recorded. Blood samples were taken prior and 18 hours after IMN. Inflammatory response was analyzed by changes in plasma IL-6 levels, monocyte (HLA-DR) and PMN phenotype (MAC-1 and responsiveness for the innate immune stimulus fMLP in the context of active FcγRII).
resultsPlasma IL-6 was significantly enhanced in severely injured patients compared to patients with isolated femur fractures and matched controls (P = 0.005; P = 0.018). This enhanced inflammatory tone was associated with a lower percentage HLA-DR positive monocytes (P = 0.002). The systemic PMN compartment was activated, characterized by an increased MAC-1 expression and a significantly decreased sensitivity for the innate stimulus fMLP Interestingly the PMN compartment was not affected by IMN.
conclusionsMultitrauma patients were characterized by a marked activation of the systemic inflammatory response, associated with a systemic activation of the monocyte and PMN compartments. IMN particularly affected the monocyte arm of the systemic innate immune system.
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Registered trials
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