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Stimulation of the inflammatory system by reamed and unreamed nailing of femoral fractures

1999; British Editorial Society of Bone & Joint Surgery; Volume: 81; Issue: 2 Linguagem: Inglês

10.1302/0301-620x.81b2.8988

2044-5377

Peter V. Giannoudis, R. M. Smith, Mark C. Bellamy, J. F. Morrison, R. A. Dickson, P J Guillou,

Orthopedic Infections and Treatments

It has been suggested that reamed intramedullary nailing of the femur should be avoided in some patients with multiple injuries. We have studied prospectively the effect of femoral reaming on the inflammatory process as implicated in the pathogenesis of acute respiratory distress syndrome (ARDS) and multiple-organ failure (MOF). We studied changes in the levels of serum interleukin-6 (IL-6) (proinflammatory cytokine), neutrophil CD11b (C3) receptor expression (activated neutrophil adhesion molecule), serum soluble intracellular adhesion molecule (s-ICAM-1), serum soluble E-selectin (the soluble products of endothelial adhesion molecules) and plasma elastase (neutrophil protease) in a series of patients with femoral fractures treated by nailing. We have also compared reamed nailing with unreamed nailing.