An increase in myeloid cells after severe injury is associated with normal fracture healing : a retrospective study of 62 patients with a femoral fracture

Autor: Leo Koenderman, Luke P. H. Leenen, Imo E. Hoefer, Albert Huisman, Maarten J. ten Berg, Wouter W. van Solinge, Marjolein Heeres, Lillian Hesselink, Karlijn J P van Wessem, Falco Hietbrink, Okan W. Bastian
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Male
Fracture Healing/physiology
Leukocyte Count
Injury Severity Score
Fracture Fixation
80 and over
Myeloid Cells
Orthopedics and Sports Medicine
Orthopedic surgery
Fracture Healing
Aged
80 and over
Major trauma
General Medicine
Femoral fracture
Femoral Fractures/blood
Middle Aged
C-Reactive Protein
Female
Femoral Fractures
Adult
medicine.medical_specialty
Adolescent
Myeloid Cells/pathology
Fractures
Ununited/blood
Nonunion
Bone healing
Article
03 medical and health sciences
Young Adult
medicine
Fracture Fixation/methods
Journal Article
Humans
Peripheral blood cell
Femur
Aged
Retrospective Studies
business.industry
Platelet Count
C-Reactive Protein/metabolism
Retrospective cohort study
medicine.disease
Surgery
030104 developmental biology
Fractures
Ununited
Erythrocyte Count
Ununited/blood
business
Fractures
RD701-811
Zdroj: Acta Orthopaedica, 89(5), 585. Informa Healthcare
Acta Orthopaedica
Acta Orthopaedica, Vol 89, Iss 5, Pp 585-590 (2018)
ISSN: 1745-3674
Popis: Background and purpose—Nonunion is common in femoral fractures. Previous studies suggested that the systemic immune response after trauma can interfere with fracture healing. Therefore, we investigated whether there is a relation between peripheral blood cell counts and healing of femur fractures. Patients and methods—62 multi-trauma patients with a femoral fracture presenting at the University Medical Centre Utrecht between 2007 and 2013 were retrospectively included. Peripheral blood cell counts from hematological analyzers were recorded from the 1st through the 14th day of the hospital stay. Generalized estimating equations were used to compare outcome groups. Results—12 of the 62 patients developed nonunion of the femoral fracture. The peripheral blood-count curves of total leukocytes, neutrophils, monocytes, lymphocytes, and platelets were all statistically significantly lower in patients with nonunion, coinciding with significantly higher CRP levels during the first 2 weeks after trauma in these patients. Interpretation—Patients who developed femoral nonunion after major trauma demonstrated lower numbers of myeloid cells in the peripheral blood than patients with normal fracture healing. This absent rise of myeloid cells seems to be related to a more severe post-traumatic immune response.
Databáze: OpenAIRE
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