Comparison of systemic inflammatory response in patients with trochanteric region fracture fixation with Dynamic Hip Screw versus Proximal Femoral Nail

doctoral thesis

• Title (croatian): Usporedba sustavnoga upalnoga odgovora u bolesnika u kojih je prijelom u području trohantera saniran Dynamic Hip Screw ostecsintezom i onih liječenih Proximal Femoral Nail metodom
• Author: Kushtrim Grezda
• Mentor: Mislav Jelić (mentor)
• Committee member: Tomislav Smoljanović (predsjednik povjerenstva)
• Committee member: Domagoj Delimar (član povjerenstva)
• Committee member: Vedran Katavić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Orthopedics); Zagreb
• Defense date and country: 2024-10-22, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Orthopedics
• Universal decimal classification (UDC): 617 - Surgery. Orthopaedics. Ophthalmology

Abstract

Objective: This study aimed to investigate the differences in the early postoperative inflammatory response after treatment of trochanteric region fractures using a dynamic hip screw (DHS) compared with proximal femoral nail (PFN).

Methods: In this prospective comparative study, 52 patients with Working Group for Osteosynthesis Problems (Ger. Arbeitsgemeinschaft für Osteosynthesefragen (AO))/The Orthopaedic Trauma Association (OTA) classification (AO/OTA) 31. A1–31.A2 pertrochanteric fractures were enrolled and allocated to one of two groups based on the treatment type: DHS group
(n = 26, mean age = 78.9±7.1 years) and PFN group (n = 26, mean age = 79.4±7.2 years). Operation time was recorded in both groups. In each patient, circulating levels of interleukin-6 (IL-6), Creactive protein (CRP), and the erythrocyte sedimentation rate (ESR) were measured from blood samples collected 1 hour preoperatively and 24 hours postoperatively.

Results: The operation time was slightly shorter in the PFN group than in the DHS group (38.3±15.9 and 51.2±22.1 min, respectively; P = 0.03). DHS and PFN both increased IL-6 (141.45±90.21 and 93.12±68.23 pg/mL, respectively), CRP (97.56±31.97 and 103.25±32.01 mg/L, respectively) levels, and the ESR (35.34±20.12 and 36.14±20.94 mm/h, respectively) 24
hours postoperatively. However, PFN compared to DHS resulted in a lesser increase from baseline to 24 hours postoperatively only in IL-6 (57.43±60.13 vs. 122.41±77.54 pg/mL, respectively; P = 0.011).

Conclusion: The results of this study have shown that PFN induced a lower early postoperative inflammatory response, based on the assessment of IL-6, compared to DHS after surgical treatment of patients with pertrochanteric fractures.

Abstract (croatian)

Uvod: Cilj ovog istraživanja bio je istražiti razlike u indukciji ranog postoperativnog upalnog odgovora nakon liječenja pertrohanternih prijeloma dinamičkim vijkom kuka (DHS) ili proksimalnim femoralnim čavlom (PFN).

Metode: 52 pacijenta s pertrohanternim prijelomima klasificiranim prema klasifikaciji radne skupine za osteosintezu (njem. Arbeitsgemeinschaft für Osteosynthesefragen (AO))/The Orthopaedic Trauma Association (OTA) classification (AO/OTA) 31.A1–31.A2) uključeno je u jednu od dvije skupine na temelju vrste liječenja: skupina DHS, i skupina PFN. Vrijeme operacije bilježeno je u obje skupine. Kod svakog pacijenta, cirkulirajuće razine interleukina-6 (hs-IL-6), Creaktivnog
proteina (CRP), brzine sedimentacije eritrocita (ESR) mjerene su iz uzoraka krvi prikupljenih 1 sat prije operacije i 24 sata poslije operacije.

Rezultati: Vrijeme operacije bilo je nešto kraće u skupini PFN nego u skupini DHS (38,3±15,9 odnosno 51,2±22,1 min; P = 0,03). DHS i PFN povećali su hs-IL-6 (141,45±90,21 odnosno 93,12±68,23 pg/mL), CRP (97,56±31,97 odnosno 03,25±32,01 mg/L) i ESR (35,34±20,12 odnosno 36,14±20,94 mm/h) 24 sata postoperativno.

Zaključak: PFN inducira niži rani postoperativni upalni odgovor na temelju procjene hs-IL-6, u usporedbi s DHS u bolesnika s pertrohanternim prijelomima nakon liječenja.

• Keywords: Dynamic hip screw; Inflammation; Pertrochanteric fractures; Proximal femoral nail
• Keywords (croatian): Dinamički vijak kuka; upala; pertrohanterni prijelomi; proksimalni bedreni čavao
• Language: english
• URN:NBN: urn:nbn:hr:105:237796
• Promotion: 2024
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 68 str.
• File origin: Born digital
• Access conditions: Open access
• Public note: Komentor: Cen Bytyqi
• Created on: 2024-11-27 13:13:26