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Erschienen in: Wiener klinische Wochenschrift 11-12/2022

31.05.2022 | original article

Evaluation of the effect of preoperative hemoglobin level and proinflammatory factors on intertrochanteric fracture union

verfasst von: Amir Sabbaghzadeh, Sona Bonakdar, Mona Gorji, MD Morteza Gholipour

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 11-12/2022

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Summary

Background

Intertrochanteric fractures are associated with high mortality and morbidity, so these patients should undergo fracture fixation surgery immediately. Despite surgery, the possibility of fracture fusion may not occur due to the association with various causes. Therefore, our aim is to investigate these factors (TNF‑a, IL‑1, Hb) and their effect on fracture union after fixation.

Methods

From 2018 to 2020, at our orthopedic trauma center, 163 patients older than 50 years with intertrochanteric fractures underwent DHS fixation surgery. Patients were divided into anemic and non-anemic groups in terms of preoperative hemoglobin level (standard hemoglobin 11 mg/dl). For 3 months, patients were assessed for union and failure fixation criteria, levels of proinflammation (TNF‑α, IL-1) and level of hemoglobin.

Results

The results show that out of 163 patients with fractures, at the time of initial admission, 74 patients had less than 11 hemoglobin g/dl. Patients with union fractures had higher hemoglobin levels than patients with non-union (11.71 ± 1.51 versus 11.24 ± 1.96), which was statistically significant between hemoglobin and union level (p = 0.030). At the end of the third visit (third month), 44 (59.5%) anemic patients received union completly, while among the patients with normal hemoglobin level, 32 (36%) received union bread, which was statistically significant (p = 0.003). There were no statistically significant differences between proinflammatory factors before surgery and 3 months after surgery (p > 0.05).

Conclusion

Due to the effect of anemia and proinflammatory factors in the process of healing fractures and bone formation and creating musculoskeletal balance, low hemoglobin level before surgery has a significant effect on fracture union and failure of fixation. So it is recommended to correct this anemia in these patients before surgery and during follow-up.
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Metadaten
Titel
Evaluation of the effect of preoperative hemoglobin level and proinflammatory factors on intertrochanteric fracture union
verfasst von
Amir Sabbaghzadeh
Sona Bonakdar
Mona Gorji
MD Morteza Gholipour
Publikationsdatum
31.05.2022
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 11-12/2022
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-022-02042-x