Stimulation of the local femoral inflammatory response to fracture and intramedullary reaming - A preliminary study of the source of the second hit phenomenon
Stimulation of the local femoral inflammatory response to fracture and intramedullary reaming - A preliminary study of the source of the second hit phenomenon
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DOI：
10.1302/0301-620x.90b3.19688
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发表时间：
2008-03-01
影响因子：
--
通讯作者：
Giannoudis, P. V.
中科院分区：
文献类型：
--
作者：
Morley, J. R.;Smith, R. M.;Giannoudis, P. V.
我们对需要髓内钉固定的股骨干骨折患者进行了一项前瞻性研究，以检验股骨髓腔可能是二次撞击现象的潜在来源这一假设。我们测定了骨折和随后的髓内扩髓后局部股骨髓内和外周白细胞介素-6（IL-6）的释放，在所有患者中，与股骨对照组相比，骨折导致局部股骨IL-6浓度显著增加。局部股动脉环境中的IL-6浓度显著高于患者自身外周循环中的匹配血液样本。股骨骨折后局部股骨释放IL-6的幅度与损伤严重程度评分以及骨折是否闭合或开放无关，在接受股骨髓内扩髓的患者中，证实了IL-6的进一步显著局部释放，提供了髓内扩髓可引起显著局部炎症反应的证据。
We have undertaken a prospective study in patients with a fracture of the femoral shaft requiring intramedullary nailing to test the hypothesis that the femoral canal could be a potential source of the second hit phenomenon. We determined the local femoral intramedullary and peripheral release of interleukin-6 (IL-6) after fracture and subsequent intramedullary reaming.In all patients, the fracture caused a significant increase in the local femoral concentrations of IL-6 compared to a femoral control group. The concentration of IL-6 in the local femoral environment was significantly higher than in the patients own matched blood samples from their peripheral circulation. The magnitude of the local femoral release of IL-6 after femoral fracture was independent of the injury severity score and whether the fracture was closed or open.In patients who underwent intramedullary reaming of the femoral canal a further significant local release of IL-6 was demonstrated, providing evidence that intramedullary reaming can cause a significant local inflammatory reaction.