Correlation between Peripheric Blood Markers and Surgical Invasiveness during Humeral Shaft Fracture Osteosynthesis in Young and Middle-Aged Patients

Moldovan, Flaviu

doi:10.3390/diagnostics14111112

Diagnostics

2024

DOI: 10.3390/diagnostics14111112

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Correlation between Peripheric Blood Markers and Surgical Invasiveness during Humeral Shaft Fracture Osteosynthesis in Young and Middle-Aged Patients

Flaviu Moldovan

Abstract: The treatment for humeral shaft fractures (HSFs) is still controversial, consisting of a wide variety of orthopedic osteosynthesis materials that imply different grades of invasiveness. The aim of this study is to investigate the correlation between inflammatory blood-derived markers and the magnitude of the surgical procedure in young and middle-aged patients who sustained these fractures. Observational, retrospective research was conducted between January 2018 and December 2023. It followed patients diagnose… Show more

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Correlation Between Neutrophil–Lymphocyte Ratio and Inhospital Cardiac Events in Geriatric Patients With Hip Fractures

Yu,

Cui,

Bai

2024

Mediators of Inflammation

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Background: The novel inflammatory biomarker known as the neutrophil–lymphocyte ratio (NLR) has shown great potential in predicting and prognosing many diseases. However, its correlation with postoperative inhospital major adverse cardiac events (MACEs) in geriatric patients with hip fractures remains unclear. This study investigated the relationship between NLR and postoperative inhospital MACEs among geriatric patients with hip fractures.Methods: We enrolled geriatric patients with hip fractures who were hospitalized in the Department of Geriatric Traumatology and Orthopedics, Beijing Jishuitan Hospital, Capital Medical University, between January 2023 and November 2023. After surgery, the patients were transferred to the intensive care unit (ICU) for postoperative monitoring and treatment. Patients were assigned to the MACE or non‐MACE group based on the occurrence of MACEs after surgery during their hospital stay. Clinical data were retrospectively analyzed.Results: In all, 216 patients were recruited into the study: 34 in the MACE group and 182 in the non‐MACE group. Univariate and multivariate analyses revealed that a medical history of stroke (odds ratio (OR) = 2.66, 95% confidence interval (CI) = 1.18–6.01; p = 0.018) and elevated preoperative NLR (OR = 1.09, 95% CI = 1.03–1.17; p = 0.005) were significant risk factors for postoperative inhospital MACEs. The area under the curve (AUC) of preoperative NLR‐predicted MACEs was 0.65 (0.55–0.75). Patients with a preoperative NLR <6.49 were less likely to experience inhospital MACEs, demonstrating a sensitivity of 61.8% and specificity of 64.8%.Conclusion: Elevated preoperative NLR is an independent risk factor for postoperative inhospital MACEs in geriatric patients with hip fractures.

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Correlation Between Neutrophil–Lymphocyte Ratio and Inhospital Cardiac Events in Geriatric Patients With Hip Fractures

Yu,

Cui,

Bai

2024

Mediators of Inflammation

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Dynamic risk factors for complex regional pain syndrome after distal radius fracture surgery: multivariate analysis and prediction

Xu,

Liu,

Zhang

et al. 2024

BMC Musculoskelet Disord

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Background Distal radius fractures are a common orthopedic injury, particularly prevalent among elderly and osteoporotic patients. Although surgical treatment effectively restores fracture alignment and stabilizes the bone, Complex Regional Pain Syndrome (CRPS) can occur as a postoperative complication, severely impacting patients’ rehabilitation and quality of life. Therefore, assessing the risk factors for postoperative CRPS is crucial for early clinical intervention, aiming to improve recovery outcomes and overall patient well-being. Objective This study aims to dynamically evaluate the risk factors for CRPS following distal radius fracture surgery through a retrospective analysis. The goal is to provide scientific evidence for early clinical identification and intervention. Methods A retrospective analysis was conducted on 191 adult patients who underwent distal radius fracture surgery between January 2021 and December 2022, comprising 89 males and 102 females, with an average age of 59.7 ± 11.6(18–75) years. Baseline and follow-up data, including demographic information, clinical characteristics, and psychological assessments, were collected. Descriptive statistics, univariate, and multivariate logistic regression analyses were used to identify independent risk factors and assess their dynamic changes over time. Results Age, gender, occupation, fracture type, surgical method, osteoporosis, pain score (VAS), functional disability score (DASH), anxiety score (GAD-7), depression score (PHQ-9), physical therapy, and occupational therapy significantly affected the incidence of CRPS. Age and VAS scores were consistent risk factors. Female gender, internal fixation surgery, and high DASH scores posed higher risks in the early postoperative period but decreased over time. Occupation and fracture type were more significant in the mid to late postoperative period. Psychological factors were most significant in the midterm, while physical and occupational therapy were protective factors early on. Conclusion The occurrence of CRPS is the result of many factors. Elderly patients, females, and manual laborers had higher risks, with complex fractures and internal fixation surgery patients showing increased risk later on. Osteoporotic patients had higher risks in the mid to late postoperative period. VAS, DASH, GAD-7, and PHQ-9 scores were significantly associated with CRPS. Early physical and occupational therapy can effectively prevent CRPS, but further research is needed to evaluate their long-term effects.

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Comparative efficacy of operative versus conservative treatment for Rockwood type III acromioclavicular joint dislocation: a systematic review and meta-analysis of randomized controlled trials

Xie,

Fan,

Chen

et al. 2024

BMC Musculoskelet Disord

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Background Optimal management of Rockwood type III acromioclavicular joint (ACJ) dislocation is still debated. Our aim is to conduct a meta-analysis of clinical studies evaluating the functional outcomes of operative versus conservative treatment for Rockwood type III ACJ dislocation. Methods We conducted a systematic search across PubMed, EMBASE, Web of Science, and the Cochrane Library, including only randomized controlled trials (RCTs) focusing exclusively on type III ACJ dislocation. A total of 244 patients from four studies were included. Outcomes measured included Constant scores (CS), coracoclavicular distance (CCD), pain, and complication rates. Heterogeneity was assessed and managed to ensure robust conclusions. Results The pooled results showed no significant difference in long-term functional outcomes, measured by CS, between surgical and conservative treatments (MD: 4.82, 95% CI: -6.42 to 16.06, P = 0.400). Surgical treatment provided better early pain relief and superior CCD at all follow-up points but did not improve long-term outcomes. Complication rates were similar for both treatments, though surgical intervention had a higher incidence of posttraumatic osteoarthritis and hardware-related issues. Conservative treatment resulted in fewer complications and comparable long-term results. Conclusions Based on the evidence, while surgical treatment may offer early benefits in pain relief and CCD improvement, it does not enhance long-term functional outcomes and is associated with higher specific complication rates. Conservative treatment provides a viable alternative with fewer complications and similar long-term outcomes. These findings highlight the need for individualized treatment plans based on patient-specific factors and suggest further high-quality, long-term studies to refine management strategies for Type III AC joint dislocations.

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Correlation between Peripheric Blood Markers and Surgical Invasiveness during Humeral Shaft Fracture Osteosynthesis in Young and Middle-Aged Patients

Cited by 5 publications

References 37 publications

Correlation Between Neutrophil–Lymphocyte Ratio and Inhospital Cardiac Events in Geriatric Patients With Hip Fractures

Correlation Between Neutrophil–Lymphocyte Ratio and Inhospital Cardiac Events in Geriatric Patients With Hip Fractures

Dynamic risk factors for complex regional pain syndrome after distal radius fracture surgery: multivariate analysis and prediction

Comparative efficacy of operative versus conservative treatment for Rockwood type III acromioclavicular joint dislocation: a systematic review and meta-analysis of randomized controlled trials

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