Effect of femoral fracture and intramedullary fixation on lung capillary leak.
BACKGROUND
Pulmonary injury is an important complication in the trauma patient with long-bone fractures. The purpose of this study was to determine the effect of femoral fracture or fracture and intramedullary fixation on lung capillary leak. The contribution of leukocytes to lung injury in this model was also determined.


METHODS
The pulmonary capillary filtration coefficient was determined in lungs of rats after femur fracture or fracture and reamed or unreamed intramedullary fixation. Pulmonary arterial vascular resistance and lung neutrophil content were also determined.


RESULTS
Fracture alone did not cause lung injury, whereas fracture and intramedullary fixation elicited lung capillary leak. Fracture alone and intramedullary fixation increased pulmonary vascular resistance, whereas unreamed intramedullary fixation caused lung leukosequestration.


CONCLUSIONS
Femoral fracture alone does not cause an increase in pulmonary microvascular permeability. Femoral fracture and intramedullary fixation causes lung capillary leak, which is not increased by reaming the femoral canal.
Willis
B H
BH
Department of Orthopedic Surgery, Louisiana State University Medical Center, Shreveport 71130-3932, USA.
Carden
D L
DL
Sadasivan
K K
KK
D000818:Animals; D019559:Capillary Leak Syndrome / Q000209:etiology*; D002199:Capillary Permeability; D005264:Femoral Fractures / Q000150:complications* / Q000601:surgery; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000379:methods; D008168:Lung / Q000201:enzymology; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D009195:Peroxidase / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D014655:Vascular Resistance
D009195:Peroxidase