Femoral nailing-related coagulopathy determined by first-hit magnitude: an animal study

Clinical Orthopaedics and Related Research
P V GiannoudisHans-Christoph Pape

Abstract

We asked whether coagulopathy worsened during femoral intramedullary nailing in the presence of lung contusion and hemorrhagic shock and whether reamed or unreamed nailing influenced these results. In 30 Merino sheep, we induced hemorrhagic shock and/or standardized lung contusion followed by femoral nailing. Six groups of five each were assigned as follows: thoracotomy control groups treated with reamed or unreamed nailing, lung contusion groups treated with reamed or unreamed nailing, and shock and lung contusion groups treated with reamed or unreamed nailing. After lung contusion alone (first hit), the serum values of antithrombin III, factor V, and fibrinogen were considerably altered after reamed and unreamed femoral nailing (second hit) 4 hours postoperatively. In the lung contusion and shock groups, we found a substantial reduction for all serum coagulative parameters between baseline and fixation after reamed and unreamed nailing. The magnitude of the first hit is increased if hemorrhagic shock is added to a lung contusion determined by hemostatic reactions. The magnitude of the injury appears equally important as the type of subsequent surgery and should be considered in planning for fracture fixation in patients at hi...Continue Reading

References

Sep 1, 1992·The Journal of Trauma·R L ReedR P Fischer
May 1, 1992·Critical Care Medicine·S GandoM Kubota
Nov 1, 1990·Injury·G FolleråsB O Thoresen
Jul 1, 1969·Journal of Applied Physiology·S E LevyD H Simmons
Jan 1, 1984·Seminars in Thrombosis and Hemostasis·H C Kwaan
Nov 1, 1995·Current Problems in Surgery·A B PeitzmanR L Simmons
Nov 1, 1993·The Journal of Bone and Joint Surgery. British Volume·S P HughesI D McCarthy
Jan 1, 1994·Chest·N HasegawaT A Raffin
Dec 1, 1995·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·O E DahlT Lyberg
Feb 1, 1997·The Journal of Bone and Joint Surgery. American Volume·P J DuweliusD Wheeler
Jul 29, 1998·Intensive Care Medicine·P V GiannoudisR M Smith
Aug 15, 1998·Vox Sanguinis·S Hiippala
Oct 23, 1998·The Journal of Trauma·H C PapeH Tscherne
Mar 24, 1999·The Journal of Trauma·P R WolinskyK Johnson
Apr 16, 1999·The Journal of Bone and Joint Surgery. British Volume·P V GiannoudisP J Guillou
Apr 30, 1999·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·A KröpflG Schlag
Dec 11, 1999·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·H PapeH Tscherne
Apr 25, 2000·The American Surgeon·K R KrauseP J Bendick
Feb 13, 2001·Journal of Applied Physiology·J G YoungerZ A Ravage
Oct 18, 2001·The Journal of Bone and Joint Surgery. British Volume·C M RobinsonJ Christie
Jul 4, 2002·American Journal of Surgery·Hans-Christoph PapeChristian Krettek
Jun 10, 2003·The Journal of Bone and Joint Surgery. British Volume·P V Giannoudis
Jun 13, 2003·ANZ Journal of Surgery·Ian HarrisJudie Walton
Jun 19, 2003·The Journal of Trauma·Karim BrohiTimothy Coats
Jul 12, 2003·The Journal of Trauma·Jana B A MacLeodMary Murtha
Jan 27, 2004·The Journal of Pathology·Madhav Bhatia, Shabbir Moochhala
Feb 26, 2004·Critical Care Clinics·Thomas G DeLoughery
Jun 19, 2004·Injury·P V Giannoudis, H C Pape
Jun 19, 2004·Injury·Frank HildebrandHans-Christoph Pape

❮ Previous
Next ❯

Citations

Jun 1, 2012·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·M PerlF Gebhard
Dec 17, 2009·Clinical Orthopaedics and Related Research·Nikolaos G LasanianosPeter V Giannoudis

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.