Comparison of blood sugar levels in the limb with open IIIC fractures and normal limb (unraveling the link).

Background: Prompt and accurate diagnosis of vascular compromise in open fractures is essential for optimising outcomes and preventing long-term complications. Current methods of physical examination and imaging techniques are time-consuming or inconclusive. In open IIIC fractures, there may be alterations in blood flow and tissue perfusion. No one till date has compared blood sugar levels in the limbs and found a correlation between the severity of vascular injury and blood glucose levels. Methods: 24 patients with suspected lower limb vascular injuries (open type 3c) were recruited to the study. Blood glucose levels samples were simultaneously checked from both the affected and unaffected limb via glucometer. To confirm the presence of vascular injury, USG Doppler or Ct angiography was done. Results: The mean age of the patients was 40.4 (17-73). Out of 16 patients with vascular injuries, 14 were correctly diagnosed by this novel method and 7 patients without vascular injury, 6 patients were successfully screened using this method. The sensitivity of the test is 87.5 %, which means it is quite good at successfully screened using this method. Conclusion: Disrupted blood flow due to vascular injury can lead to tissue hypoxia (oxygen deprivation). In response to hypoxia, cells undergo anaerobic metabolism, producing lactic acid as a byproduct. This use of glucose in the absence of oxygen to form lactic acid can lead to a corresponding fall in blood glucose levels within the affected limb. Identification of a significant difference in blood glucose levels between the limbs can be a reliable tool in the screening of vascular injuries, This study can aide in establishing a reliable threshold for blood glucose difference to diagnose vascular injury and demonstrating the feasibility of using blood glucose measurement as a rapid and point-of-care diagnostic tool.