Stimulation of the local femoral inflammatory response to fracture and intramedullary reaming: a preliminary study of the source of the second hit phenomenon.

@article{Morley2008StimulationOT,
  title={Stimulation of the local femoral inflammatory response to fracture and intramedullary reaming: a preliminary study of the source of the second hit phenomenon.},
  author={J R Morley and R. Malcolm Smith and Hans-Christoph Pape and David A. Macdonald and L K Trejdosiewitz and P. V. Giannoudis},
  journal={The Journal of bone and joint surgery. British volume},
  year={2008},
  volume={90 3},
  pages={
          393-9
        }
}
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… 
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In the polytraumatized patients with femoral shaft fractures operated with primary IMN the authors observed a substantial response related to the initial trauma, but could not demonstrate any major additional IMN-related impact on the inflammatory responses or on the cardiopulmonary function parameters.
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It is revealed that reamed femoral nailing (reamed) is associated with more prominent immunological cardiac alterations compared to nailing without reaming (non-reamed), which suggests that the choice of the initial fracture treatment strategy might be crucial for the overall outcome as well as for any post-traumatic cardiac consequences.
A PROSPECTIVE STUDY OF SURGICAL MANAGEMENT OF FRACTURE SHAFT FEMUR WITH CLOSED INTRAMEDULLARY INTERLOCKING NAIL
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TLDR
For the treatment of complex tibial plateau fractures, modified dual plating and less invasive stabilization system were both better than unilateral locking plate internal fixation in treatment effects, but no significant differences were found in curative effects and lowering serum inflammatory factors levels of between Groups A and B.
Standardized porcine unilateral femoral nailing is associated with changes in PMN activation status, rather than aberrant systemic PMN prevalence
TLDR
This study reveals that a femur fracture and subsequent IMN in a controlled setting in pigs is associated with enhanced activation status of circulatory PMNs, preserved PMN-responsiveness and unaltered circulatoryPMN-presence, indicating that monotrauma plus IMN is a specific and substantial stimulus for the cellular immune system.
Intramedullary Nailing of the Femur: Current Concepts Concerning Reaming
TLDR
The history and current knowledge of intramedullary reaming with respect to problems associated with its use and the evolution of treatment modalities and their clinical applicability for orthopaedic trauma care are discussed.
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References

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TLDR
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TLDR
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TLDR
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TLDR
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TLDR
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TLDR
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TLDR
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TLDR
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