Alteration of Body Temperature, Erythrocyte Sedimentation Rate, and C-reactive Protein After Reamed Intramedullary Nailing: A Prospective Study

OBJECTIVES:This study was designed to confirm the clinical observation that patients undergoing reamed intramedullary nailing develop a high temperature in the early postoperative period and to further investigate this reaction by studying the alteration of biologic markers, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), during the early postoperative period. DESIGN:Body temperature, ESR, and CRP were monitored on admission, preoperatively, and postoperatively (1st, 3rd, and 10th days) in 30 consecutive patients who sustained isolated, closed femoral, or tibial diaphyseal fractures and were treated with reamed intramedullary nailing (study group). The same biologic parameters were monitored in 35 consecutive patients who sustained isolated, closed, intertrochanteric fractures of the femur at the same period of time and were treated with a Dynamic Hip Screw® (control group). Polytrauma patients or patients with pathologic problems or complications that could influence the results were excluded from the study. RESULTS:Body temperature, ESR, and CRP rise significantly (P < 0.0001) after reamed intramedullary nailing. CONCLUSIONS:Reamed intramedullary nailing causes significant inflammatory reaction that warrants further investigation. Knowledge that biologic markers are altered after reamed intramedullary nailing could help toward better postoperative management and undisturbed commencement of a physiotherapy program, and also toward better assessment and diagnosis of early postoperative complications, such as infection.