title: The systemic inflammatory response following femoral canal reaming using the reamer-irrigator-aspirator (RIA) device.
abstract: We evaluated the peripheral release of inflammatory mediators after femoral fracture and subsequent intramedullary reaming using the RIA reamers. IL-6 was elevated after trauma, and reaming with RIA induced a measurable second hit response. However, despite a higher ISS, the levels of IL-6 in the RIA group were similar to the levels measured in a group of patients where reaming of the femoral canal was performed using conventional reamers. There was one death related to fat embolism syndrome in the conventional reamers group. However, the overall incidence of complications was low and similar between the 2 groups of studied patients. In polytrauma patients, large scale studies are desirable to evaluate further the immuno-inflammatory response using the RIA reamers prior to the instrumentation of the femoral canal.
authors.affiliation: Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals NHS Trust, School of Medicine, University of Leeds, UK. pgiannoudi@aol.com
authors.forename: P V
authors.initials: PV
authors.lastname: Giannoudis
authors.forename: H B
authors.initials: HB
authors.lastname: Tan
authors.forename: S
authors.initials: S
authors.lastname: Perry
authors.forename: C
authors.initials: C
authors.lastname: Tzioupis
authors.forename: N K
authors.initials: NK
authors.lastname: Kanakaris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003646:Debridement / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D004620:Embolism, Fat / Q000209:etiology / Q000401:mortality; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000276:immunology* / Q000378:metabolism / Q000601:surgery; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D015850:Interleukin-6 / Q000276:immunology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology / Q000276:immunology* / Q000401:mortality; D007507:Therapeutic Irrigation / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
chemical_list: D018836:Inflammation Mediators; D015850:Interleukin-6