eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
Current issue Archive Manuscripts accepted About the journal Special issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
vol. 15
Clinical research

Evaluation of inflammatory response in patients undergoing surgical treatment for early and delayed femoral fractures

Mehdi Moghtadaei, Babak Otoukesh, Hamidreza Pazoki-Toroudi, Bahram Boddouhi, Ali Yeganeh

Arch Med Sci 2019; 15, 1: 141–145
Online publish date: 2016/10/17
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
It has been shown that long bone fractures are correlated with the inflammatory response. In the initial injury, surgical reduction and fixation of fractures induce the immunoinflammatory response. This study aimed to evaluate serum variation of inflammatory markers in patients undergoing surgical treatment for early and delayed femoral fractures.

Material and methods
This study aimed to evaluate serum variation of inflammatory markers in patients undergoing surgical treatment for early and delayed femoral fractures. The patients were randomly divided into two groups using the method of block randomization including early surgery (within 24 h) and delayed surgery (after 48 h). Serum levels of inflammatory markers in both groups including interleukin (IL)-1, 5, 6, tumor necrosis factor α (TNF-α) and interferon γ (IFN-γ) were determined using specific kits. From each patient 10 ml blood was collected for cytokine assay in their serum.

Our findings suggest that serum levels of IL-8 were markedly decreased from 12 h until 48 h postoperatively (p < 0.05). Moreover, the results indicated that serum levels of TNF-α were significantly increased in the early hours, but after 48 h a decreasing trend was detected (p < 0.05). Furthermore, serum levels of IL-10, IFN-γ, and IL-6 were significantly increased from 12 h until 48 h postoperatively (p < 0.05).

The inflammatory status of the patient may be a useful adjunct in clinical decisions. With an improved understanding of the molecular basis of the inflammatory response, and by identifying relevant clinical markers of inflammation, surgeons can better manage the timing of surgical stabilization.


inflammation, tumor necrosis factor, interleukin, patient, femoral

Galle C, De Maertelaer V, Motte S. Early inflammatory response after elective abdominal aortic aneurysm repair: a comparison between endovascular procedure and conventional surgery. J Vasc Surg 2000; 32: 234-46.
Munoz M, Garcia-Vallejo JJ, Sempere JM, et al. Acute phase response in patients undergoing lumbar spinal surgery: modulation by perioperative treatment with naproxen and famotidine. Eur Spine J 2004; 13: 467-73.
Pape HC, Schmidt RE, Rice J, et al. Biochemical changes after trauma and skeletal surgery of the lower extremity: quantification of the operative burden. Crit Care Med 2000; 28: 3441-8.
Wakai A, Wang JH, Winter DC, et al. Tourniquet-induced systemic inflammatory response in extremity surgery. J Trauma 2001; 51: 922-6.
Faist E, Baue AE, Dittmer H, Heberer G. Multiple organ failure in polytrauma patients. J Trauma 1983; 23: 775-87.
Lane MK, Nahm NJ, Vallier HA. Morbidity and mortality of bilateral femur fractures. Orthopedics 2015; 38: e588-92.
Giannoudis PV, Cohen A, Hinsche A, et al. Simultaneous bilateral femoral fractures: systemic complications in 14 cases. Int Orthop 2000; 24: 264-7.
Rankin JA. Biological mediators of acute inflammation. AACN Clin Issues 2004; 15: 3-17.
Robinson CM. Current concepts of respiratory insufficiency syndromes after fracture. J Bone Joint Surg Br 2001; 83: 781-91.
Finnerty CC, Herndon DN, Przkora R, et al. Cytokine expression profile over time in severely burned pediatric patients. Shock 2006; 26: 13Y19.
Zhang H, Sun T, Liu Z, Zhang J. Systemic inflammatory responses and lung injury following hip fracture surgery increases susceptibility to infection in aged rats. Mediators Inflamm 2013; 2013: 536435.
Neumaier M, Vester H, Martetschläger F, Freude T. Optimaler Zeitpunkt zur prothetischen Versorgung von Schenkelhalsfrakturen 2011; 82: 921-6.
Harwood PJ, Giannoudis PV, van Griensven M, Krettek C, Pape HC. Alterations in the systemic inflammatory response after early total care and damage control procedures for femoral shaft fracture in severely injured patients. J Trauma 2005; 58: 446-52.
Nakamura H, Yoshino S, Shiga H, Tanaka H, Katsumata S. A case of spontaneous femoral neck fracture associated with multicentric reticulohistiocytosis: oversecretion of interleukin-1beta, interleukin-6, and tumor necrosis factor alpha by affected synovial cells. Arthritis Rheum 1997; 40: 2266-70.
Tiansheng S, Xiaobin C, Zhi L, et al. Is damage control orthopedics essential for the management of bilateral femoral fractures associated or complicated with shock? An animal study. J Trauma 2009; 67: 1402-11.
Buzdon MM, Napolitano LM, Shi HJ, et al. Femur fracture induces site-specific changes in T-cell immunity. J Surg Res 1999; 82: 201-8.
Pape HC, Grimme K, Van Griensven M, et al. Impact of intramedullary instrumentation versus damage control for femoral fractures on immunoinflammatory parameters: prospective randomized analysis by the EPOFF Study Group. J Trauma 2003; 55: 7-13.
Bączyk G, Samborski W, Jaracz K. Evaluation of the quality of life of postmenopausal osteoporotic and osteopenic women with or without fractures. Arch Med Sci 2016; 12: 819-27.
Dytfeld J, Marcinkowska M, Drwęska-Matelska N, Michalak M, Horst-Sikorska W. Association analysis of the COL1A1 polymorphism with bone mineral density and prevalent fractures in Polish postmenopausal women with osteoporosis. Arch Med Sci 2016; 12: 288-94.
Sadr SSH, Javanbakht J, Norouzi Javidan A, Ghaffarpour M, Safoura Khamse S. Descriptive epidemiology: prevalence, incidence, sociodemographic factors, socioeconomic domains, and quality of life of epilepsy: an update and systematic review. Arch Med Sci in press DOI: 10.5114/aoms.2016.60377.
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe