Alteration of body temperature, erythrocyte sedimentation rate, and C-reactive protein after reamed intramedullary nailing: a prospective study.
OBJECTIVE
This study was designed to confirm the clinical observation that patients undergoing reamed intramedullary nailing develop a high temperature in the early postoperative period and to further investigate this reaction by studying the alteration of biologic markers, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), during the early postoperative period.


METHODS
Body temperature, ESR, and CRP were monitored on admission, preoperatively, and postoperatively (1st, 3rd, and 10th days) in 30 consecutive patients who sustained isolated, closed femoral, or tibial diaphyseal fractures and were treated with reamed intramedullary nailing (study group). The same biologic parameters were monitored in 35 consecutive patients who sustained isolated, closed, intertrochanteric fractures of the femur at the same period of time and were treated with a Dynamic Hip Screw(R) (control group). Polytrauma patients or patients with pathologic problems or complications that could influence the results were excluded from the study.


RESULTS
Body temperature, ESR, and CRP rise significantly (P < 0.0001) after reamed intramedullary nailing.


CONCLUSIONS
Reamed intramedullary nailing causes significant inflammatory reaction that warrants further investigation. Knowledge that biologic markers are altered after reamed intramedullary nailing could help toward better postoperative management and undisturbed commencement of a physiotherapy program, and also toward better assessment and diagnosis of early postoperative complications, such as infection.
Garnavos
Christos
C
1st Orthopaedic Department, Evangelismos General Hospital, Athens, Greece. garnavos@eexi.gr
Xirou
Stamatia-Tina
ST
Nikolatos
Andreas
A
Kanakaris
Nikolaos
N
Tzortzi
Paraskevi
P
Balbouzis
Theodoros
T
Papavasiliou
Nikolaos
N
D000328:Adult; D015415:Biomarkers / Q000032:analysis*; D001799:Blood Sedimentation; D001831:Body Temperature / Q000502:physiology; D001858:Bone Nails; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006400:Hematocrit; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods; D011336:Probability; D011859:Radiography; D012680:Sensitivity and Specificity; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
D015415:Biomarkers; D002097:C-Reactive Protein