Evidence map›Paper›PMID 34114052›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022

Standardized porcine unilateral femoral nailing is associated with changes in PMN activation status, rather than aberrant systemic PMN prevalence.

Michel Paul Johan Teuben, Roman Pfeifer, Klemens Horst, Tim-Philipp Simon, Marjolein Heeres, Yannik Kalbas, Taco Blokhuis, Frank Hildebrand, Leo Koenderman, Hans-Christoph Pape and 2 more

Open access · hybridAbstract read
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Neutrophil cell surface receptor dynamics following trauma: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Pooled it
  2. Article
  3. Defining the early systemic neutrophil signature after severe trauma: decreased CD10/CD16 levels on admission precedes metabolic dysregulation.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Article
  4. Review
  5. Focus on biomarkers, confounders and new therapeutic approaches in trauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 2 countries.

Michel Paul Johan TeubenDepartment of Traumatology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. michel.teuben@usz.ch.
Roman PfeiferDepartment of Traumatology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Klemens HorstDepartment of Trauma and Reconstructive Surgery, RWTH University Hospital Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
Tim-Philipp SimonDepartment of Intensive Care and Intermediate Care, RWTH University Hospital Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
Marjolein HeeresDepartment of Traumatology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Yannik KalbasDepartment of Traumatology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Taco BlokhuisDepartment of Surgery, University Hospital Maastricht, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
Frank HildebrandDepartment of Trauma and Reconstructive Surgery, RWTH University Hospital Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
Leo KoendermanLaboratory for Translational Immunology, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Hans-Christoph PapeDepartment of Traumatology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Luke LeenenDepartment of Traumatology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
TREAT-Research Collaboration
Heidelberg University · DEUniversity Medical Center Utrecht · NLUniversity Hospital Heidelberg · DEUniversitätsklinikum Aachen · DERWTH Aachen University · DEMaastricht University Medical Centre · NLUtrecht University · NL

Funding

AO Foundation S-14-14P,
6 · The paper itself

Abstract

purposeIntramedullary nailing (IMN) of fractures is associated with increased rates of inflammatory complications. The pathological mechanism underlying this phenomenon is unclear. However, polymorphonuclear granulocytes (PMNs) seem to play an important role. We hypothesized that a femur fracture and standardized IMN in pigs is associated with altered appearance of PMNs in circulation and enhanced activation status of these cells.

methodsA porcine model including a femur fracture and IMN was utilized. Animals were randomized for control [anesthesia + mechanical ventilation only (A/MV)] and intervention [A/MV and unilateral femur fracture (FF) + IMN] conditions. PMN numbers and responsiveness, integrin (CD11b), L-selectin (CD62L) and Fcγ-receptor (CD16 and CD32)-expression levels were measured by flowcytometry of blood samples. Animals were observed for 72 h.

resultsCirculatory PMN numbers did not differ between groups. Early PMN-responsiveness was retained after insult. PMN-CD11b expression increased significantly upon insult and peaked after 24 h, whereas CD11b in control animals remained unaltered (P = 0.016). PMN-CD16 expression levels in the FF + IMN-group rose gradually over time and were significantly higher compared with control animals, after 48 h (P = 0.016) and 72 h (P = 0.032). PMN-CD62L and CD32 expression did not differ significantly between conditions.

conclusionThis study reveals that a femur fracture and subsequent IMN in a controlled setting in pigs is associated with enhanced activation status of circulatory PMNs, preserved PMN-responsiveness and unaltered circulatory PMN-presence. Indicating that monotrauma plus IMN is a specific and substantial stimulus for the cellular immune system. Early alterations of circulatory PMN receptor expression dynamics may be predictive for the intensity of the post traumatic response.

Indexed as

Femoral FracturesFracture Fixation, IntramedullaryAnimalsFemurGranulocytesNeutrophilsPrevalenceSwineActivation statusInflammationIntra-medullary nailingPolymorphonuclear neutrophilsPorcine modelling

Identifiers

PMID34114052
PMCPMC9192391
OpenAlexW3167754494

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.