ArticleScandinavian journal of trauma, resuscitation and emergency medicine2012
Intramedullary nailing of femoral shaft fractures in polytraumatized patients. a longitudinal, prospective and observational study of the procedure-related impact on cardiopulmonary- and inflammatory responses.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00981877 (Probiotics in the Management of Acute Rotavirus Diarrhea in Bolivian Children), which is not on this map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Probiotics in the Management of Acute Rotavirus Diarrhea in Bolivian Children: Randomized Double-blind, Controlled Trial Using Two Different Preparations
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Developments in the understanding of staging a "major fracture" in polytrauma: results from an initiative by the polytrauma section of ESTES.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Pooled it
- Using IL-6 concentrations in the first 24 h following trauma to predict immunological complications and mortality in trauma patients: a meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2018Pooled it
- Polytrauma Patients managed by Damage Control Orthopedics or Early Total Care - Assessment of Biomarkers.Journal of orthopaedic case reports · 2025Article
- Prognostic value of the systemic immune-inflammation index in critically ill elderly patients with hip fracture: evidence from MIMIC (2008-2019).Frontiers in medicine · 2024Article
- 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
- Retrograde femoral nails for emergency stabilization in multiply injured patients with haemodynamic instability.Trauma case reports · 2020Article
- Complement Activation and Organ Damage After Trauma-Differential Immune Response Based on Surgical Treatment Strategy.Frontiers in immunology · 2020Article
- Body mass index interaction effects with hyperglycemia and hypocholesterolemia modify blunt traumatic brain injury outcomes: a retrospective study.International journal of burns and trauma · 2020Article
- Damage control orthopaedics: State of the art.World journal of orthopedics · 2019Article
- 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
- Current Concepts in Orthopedic Management of Multiple Trauma.The open orthopaedics journal · 2015Article
- Prevalence, predictors and outcome of hypofibrinogenaemia in trauma: a multicentre observational study.Critical care (London, England) · 2014Observational
- Do parameters used to clear noncritically injured polytrauma patients for extremity surgery predict complications?Clinical orthopaedics and related research · 2013Article
- Changes in fibrinogen availability and utilization in an animal model of traumatic coagulopathy.Scandinavian journal of trauma, resuscitation and emergency medicine · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly intramedullary nailing (IMN) of long bone fractures in severely injured patients has been evaluated as beneficial, but has also been associated with increased inflammation, multi organ failure (MOF) and morbidity. This study was initiated to evaluate the impact of primary femoral IMN on coagulation-, fibrinolysis-, inflammatory- and cardiopulmonary responses in polytraumatized patients.
methodsTwelve adult polytraumatized patients with femoral shaft fractures were included. Serial blood samples were collected to evaluate coagulation-, fibrinolytic-, and cytokine activation in arterial blood. A flow-directed pulmonary artery (PA) catheter was inserted prior to IMN. Cardiopulmonary function parameters were recorded peri- and postoperatively. The clinical course of the patients and complications were monitored and recorded daily.
resultsMean Injury Severity Score (ISS) was 31 ± 2.6. No procedure-related effect of the primary IMN on coagulation- and fibrinolysis activation was evident. Tumor necrosis factor alpha (TNF-α) increased significantly from 6 hours post procedure to peak levels on the third postoperative day. Interleukin-6 (IL-6) increased from the first to the third postoperative day. Interleukin-10 (IL-10) peaked on the first postoperative day. A procedure-related transient hemodynamic response was observed on indexed pulmonary vascular resistance (PVRI) two hours post procedure. 11/12 patients developed systemic inflammatory response syndrome (SIRS), 7/12 pneumonia, 3/12 acute lung injury (ALI), 3/12 adult respiratory distress syndrome (ARDS), 3/12 sepsis, 0/12 wound infection.
conclusionIn the polytraumatized patients with femoral shaft fractures operated with primary IMN we observed a substantial response related to the initial trauma. We could not demonstrate any major additional IMN-related impact on the inflammatory responses or on the cardiopulmonary function parameters. These results have to be interpreted carefully due to the relatively few patients included.
trial registrationClinicalTrials.gov: NCT00981877.
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