Does the Reamer Type Influence the Degree of Lung Dysfunction After Femoral Nailing Following Severe Trauma? An Animal Study
In multiple trauma patients with lung contusion, pulmonary complications have been reported that were attributed to intramedullary stabilization of the femur. The reaming procedure of the medullary canal is thought to play a major role. We investigated whether different types of reamers might exert...
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| Veröffentlicht in: | Journal of orthopaedic trauma 1994-08, Vol.8 (4), p.300-309 |
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| container_title | Journal of orthopaedic trauma |
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| creator | Pape, Hans-Christoph Dwenger, Alexander Grotz, Martin Kaever, Volker Negatsch, Ruth Kleemann, Werner Regel, Gerd Sturm, Johannes A Tscherne, Harald |
| description | In multiple trauma patients with lung contusion, pulmonary complications have been reported that were attributed to intramedullary stabilization of the femur. The reaming procedure of the medullary canal is thought to play a major role. We investigated whether different types of reamers might exert different amounts of fat mobilization into the vascular system and different degrees of pulmonary dysfunction. Adult female Merino sheep were submitted to hemorrhagic shock (2 h, 50 mm Hg) and a unilateral lung contusion; in addition, a lung lymph fistula was created. Pulmonary capillary permeability, central venous triglyceride levels, 11-dehydro-thromboxane B2 (dh- TXB2) levels, and pulmonary artery pressure were determined. After recovery, animals were randomly assigned to intramedullary femoral nailing using several types of reamersgroup A, AO reamer (n=8); group B, Biomet reamer (n=7); group H, Howmedica reamer (n=6); group C, controls, no reaming (n=4). Intramedullary reaming caused a significant (p |
| doi_str_mv | 10.1097/00005131-199408000-00005 |
| format | Article |
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An Animal Study</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Pape, Hans-Christoph ; Dwenger, Alexander ; Grotz, Martin ; Kaever, Volker ; Negatsch, Ruth ; Kleemann, Werner ; Regel, Gerd ; Sturm, Johannes A ; Tscherne, Harald</creator><creatorcontrib>Pape, Hans-Christoph ; Dwenger, Alexander ; Grotz, Martin ; Kaever, Volker ; Negatsch, Ruth ; Kleemann, Werner ; Regel, Gerd ; Sturm, Johannes A ; Tscherne, Harald</creatorcontrib><description>In multiple trauma patients with lung contusion, pulmonary complications have been reported that were attributed to intramedullary stabilization of the femur. The reaming procedure of the medullary canal is thought to play a major role. We investigated whether different types of reamers might exert different amounts of fat mobilization into the vascular system and different degrees of pulmonary dysfunction. Adult female Merino sheep were submitted to hemorrhagic shock (2 h, 50 mm Hg) and a unilateral lung contusion; in addition, a lung lymph fistula was created. Pulmonary capillary permeability, central venous triglyceride levels, 11-dehydro-thromboxane B2 (dh- TXB2) levels, and pulmonary artery pressure were determined. After recovery, animals were randomly assigned to intramedullary femoral nailing using several types of reamersgroup A, AO reamer (n=8); group B, Biomet reamer (n=7); group H, Howmedica reamer (n=6); group C, controls, no reaming (n=4). Intramedullary reaming caused a significant (p<0.05) increase in pulmonary artery pressure in groups A and B; dh-TXB2 levels increased in all groups. Statistically significant (p<0.05) pulmonary capillary permeability damage was measured in group A only. Intramedullary femoral nailing can cause transient pulmonary hemodynamic and mediator effects as well as increased pulmonary capillary permeability. In the present study, this effect was evident in group A reamer systems only, which may be due to reamer construction.</description><identifier>ISSN: 0890-5339</identifier><identifier>EISSN: 1531-2291</identifier><identifier>DOI: 10.1097/00005131-199408000-00005</identifier><identifier>PMID: 7965291</identifier><language>eng</language><publisher>United States: Lippincott-Raven Publishers</publisher><subject>Animals ; Bone Nails ; Capillary Permeability ; Contusions - complications ; Disease Models, Animal ; Embolism, Fat - blood ; Embolism, Fat - classification ; Embolism, Fat - diagnosis ; Embolism, Fat - etiology ; Embolism, Fat - physiopathology ; Equipment Design ; Female ; Femoral Fractures - complications ; Femoral Fractures - surgery ; Fracture Fixation, Intramedullary - adverse effects ; Fracture Fixation, Intramedullary - instrumentation ; Lung Injury ; Multiple Trauma - complications ; Multiple Trauma - surgery ; Pulmonary Circulation ; Pulmonary Embolism - blood ; Pulmonary Embolism - classification ; Pulmonary Embolism - diagnosis ; Pulmonary Embolism - etiology ; Pulmonary Embolism - physiopathology ; Severity of Illness Index ; Sheep ; Shock, Hemorrhagic - complications ; Thromboxane B2 - analogs & derivatives ; Thromboxane B2 - blood ; Triglycerides - blood</subject><ispartof>Journal of orthopaedic trauma, 1994-08, Vol.8 (4), p.300-309</ispartof><rights>Lippincott-Raven Publishers.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3555-257ed8a47a674ed13ee0efcb64ad68c13222d116ee1e6834284a0348db774f543</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7965291$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pape, Hans-Christoph</creatorcontrib><creatorcontrib>Dwenger, Alexander</creatorcontrib><creatorcontrib>Grotz, Martin</creatorcontrib><creatorcontrib>Kaever, Volker</creatorcontrib><creatorcontrib>Negatsch, Ruth</creatorcontrib><creatorcontrib>Kleemann, Werner</creatorcontrib><creatorcontrib>Regel, Gerd</creatorcontrib><creatorcontrib>Sturm, Johannes A</creatorcontrib><creatorcontrib>Tscherne, Harald</creatorcontrib><title>Does the Reamer Type Influence the Degree of Lung Dysfunction After Femoral Nailing Following Severe Trauma? An Animal Study</title><title>Journal of orthopaedic trauma</title><addtitle>J Orthop Trauma</addtitle><description>In multiple trauma patients with lung contusion, pulmonary complications have been reported that were attributed to intramedullary stabilization of the femur. The reaming procedure of the medullary canal is thought to play a major role. We investigated whether different types of reamers might exert different amounts of fat mobilization into the vascular system and different degrees of pulmonary dysfunction. Adult female Merino sheep were submitted to hemorrhagic shock (2 h, 50 mm Hg) and a unilateral lung contusion; in addition, a lung lymph fistula was created. Pulmonary capillary permeability, central venous triglyceride levels, 11-dehydro-thromboxane B2 (dh- TXB2) levels, and pulmonary artery pressure were determined. After recovery, animals were randomly assigned to intramedullary femoral nailing using several types of reamersgroup A, AO reamer (n=8); group B, Biomet reamer (n=7); group H, Howmedica reamer (n=6); group C, controls, no reaming (n=4). Intramedullary reaming caused a significant (p<0.05) increase in pulmonary artery pressure in groups A and B; dh-TXB2 levels increased in all groups. Statistically significant (p<0.05) pulmonary capillary permeability damage was measured in group A only. Intramedullary femoral nailing can cause transient pulmonary hemodynamic and mediator effects as well as increased pulmonary capillary permeability. In the present study, this effect was evident in group A reamer systems only, which may be due to reamer construction.</description><subject>Animals</subject><subject>Bone Nails</subject><subject>Capillary Permeability</subject><subject>Contusions - complications</subject><subject>Disease Models, Animal</subject><subject>Embolism, Fat - blood</subject><subject>Embolism, Fat - classification</subject><subject>Embolism, Fat - diagnosis</subject><subject>Embolism, Fat - etiology</subject><subject>Embolism, Fat - physiopathology</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Femoral Fractures - complications</subject><subject>Femoral Fractures - surgery</subject><subject>Fracture Fixation, Intramedullary - adverse effects</subject><subject>Fracture Fixation, Intramedullary - instrumentation</subject><subject>Lung Injury</subject><subject>Multiple Trauma - complications</subject><subject>Multiple Trauma - surgery</subject><subject>Pulmonary Circulation</subject><subject>Pulmonary Embolism - blood</subject><subject>Pulmonary Embolism - classification</subject><subject>Pulmonary Embolism - diagnosis</subject><subject>Pulmonary Embolism - etiology</subject><subject>Pulmonary Embolism - physiopathology</subject><subject>Severity of Illness Index</subject><subject>Sheep</subject><subject>Shock, Hemorrhagic - complications</subject><subject>Thromboxane B2 - analogs & derivatives</subject><subject>Thromboxane B2 - blood</subject><subject>Triglycerides - blood</subject><issn>0890-5339</issn><issn>1531-2291</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9P2zAcxa1pCArbnzDJJ24Z_hk7J1RRCkgVSKM7W27yDc3mxJ0dr6rEH4-hhRu-2H7v82zrGSFMyU9KKnVB8pCU04JWlSA674o36QuaUJllxir6FU2IrkghOa9O0GmMfzKhCWPH6FhVpczIBD3PPEQ8rgH_AttDwMvdBvDd0LoEQw1vzgyeAgD2LV6k4QnPdrFNQz12fsDTdsyZOfQ-WIfvbee6TMy9c377unqE_xAAL4NNvb3E05wYuj6jj2Nqdt_QUWtdhO-H-Qz9nl8vr26LxcPN3dV0UdRcSlkwqaDRVihbKgEN5QAE2npVCtuUuqacMdZQWgJQKDUXTAtLuNDNSinRSsHP0Pn-3E3w_xLE0fRdrME5O4BP0ahSs4oplUG9B-vgYwzQmk3Izw07Q4l5Ld68F28-it9LOfrjcEda9dB8BA9NZ1_s_a13ubP416UtBLMG68a1-ew_-Qs2zI1i</recordid><startdate>199408</startdate><enddate>199408</enddate><creator>Pape, Hans-Christoph</creator><creator>Dwenger, Alexander</creator><creator>Grotz, Martin</creator><creator>Kaever, Volker</creator><creator>Negatsch, Ruth</creator><creator>Kleemann, Werner</creator><creator>Regel, Gerd</creator><creator>Sturm, Johannes A</creator><creator>Tscherne, Harald</creator><general>Lippincott-Raven Publishers</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199408</creationdate><title>Does the Reamer Type Influence the Degree of Lung Dysfunction After Femoral Nailing Following Severe Trauma? An Animal Study</title><author>Pape, Hans-Christoph ; Dwenger, Alexander ; Grotz, Martin ; Kaever, Volker ; Negatsch, Ruth ; Kleemann, Werner ; Regel, Gerd ; Sturm, Johannes A ; Tscherne, Harald</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3555-257ed8a47a674ed13ee0efcb64ad68c13222d116ee1e6834284a0348db774f543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Animals</topic><topic>Bone Nails</topic><topic>Capillary Permeability</topic><topic>Contusions - complications</topic><topic>Disease Models, Animal</topic><topic>Embolism, Fat - blood</topic><topic>Embolism, Fat - classification</topic><topic>Embolism, Fat - diagnosis</topic><topic>Embolism, Fat - etiology</topic><topic>Embolism, Fat - physiopathology</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Femoral Fractures - complications</topic><topic>Femoral Fractures - surgery</topic><topic>Fracture Fixation, Intramedullary - adverse effects</topic><topic>Fracture Fixation, Intramedullary - instrumentation</topic><topic>Lung Injury</topic><topic>Multiple Trauma - complications</topic><topic>Multiple Trauma - surgery</topic><topic>Pulmonary Circulation</topic><topic>Pulmonary Embolism - blood</topic><topic>Pulmonary Embolism - classification</topic><topic>Pulmonary Embolism - diagnosis</topic><topic>Pulmonary Embolism - etiology</topic><topic>Pulmonary Embolism - physiopathology</topic><topic>Severity of Illness Index</topic><topic>Sheep</topic><topic>Shock, Hemorrhagic - complications</topic><topic>Thromboxane B2 - analogs & derivatives</topic><topic>Thromboxane B2 - blood</topic><topic>Triglycerides - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pape, Hans-Christoph</creatorcontrib><creatorcontrib>Dwenger, Alexander</creatorcontrib><creatorcontrib>Grotz, Martin</creatorcontrib><creatorcontrib>Kaever, Volker</creatorcontrib><creatorcontrib>Negatsch, Ruth</creatorcontrib><creatorcontrib>Kleemann, Werner</creatorcontrib><creatorcontrib>Regel, Gerd</creatorcontrib><creatorcontrib>Sturm, Johannes A</creatorcontrib><creatorcontrib>Tscherne, Harald</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of orthopaedic trauma</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pape, Hans-Christoph</au><au>Dwenger, Alexander</au><au>Grotz, Martin</au><au>Kaever, Volker</au><au>Negatsch, Ruth</au><au>Kleemann, Werner</au><au>Regel, Gerd</au><au>Sturm, Johannes A</au><au>Tscherne, Harald</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does the Reamer Type Influence the Degree of Lung Dysfunction After Femoral Nailing Following Severe Trauma? An Animal Study</atitle><jtitle>Journal of orthopaedic trauma</jtitle><addtitle>J Orthop Trauma</addtitle><date>1994-08</date><risdate>1994</risdate><volume>8</volume><issue>4</issue><spage>300</spage><epage>309</epage><pages>300-309</pages><issn>0890-5339</issn><eissn>1531-2291</eissn><abstract>In multiple trauma patients with lung contusion, pulmonary complications have been reported that were attributed to intramedullary stabilization of the femur. The reaming procedure of the medullary canal is thought to play a major role. We investigated whether different types of reamers might exert different amounts of fat mobilization into the vascular system and different degrees of pulmonary dysfunction. Adult female Merino sheep were submitted to hemorrhagic shock (2 h, 50 mm Hg) and a unilateral lung contusion; in addition, a lung lymph fistula was created. Pulmonary capillary permeability, central venous triglyceride levels, 11-dehydro-thromboxane B2 (dh- TXB2) levels, and pulmonary artery pressure were determined. After recovery, animals were randomly assigned to intramedullary femoral nailing using several types of reamersgroup A, AO reamer (n=8); group B, Biomet reamer (n=7); group H, Howmedica reamer (n=6); group C, controls, no reaming (n=4). Intramedullary reaming caused a significant (p<0.05) increase in pulmonary artery pressure in groups A and B; dh-TXB2 levels increased in all groups. Statistically significant (p<0.05) pulmonary capillary permeability damage was measured in group A only. Intramedullary femoral nailing can cause transient pulmonary hemodynamic and mediator effects as well as increased pulmonary capillary permeability. In the present study, this effect was evident in group A reamer systems only, which may be due to reamer construction.</abstract><cop>United States</cop><pub>Lippincott-Raven Publishers</pub><pmid>7965291</pmid><doi>10.1097/00005131-199408000-00005</doi><tpages>10</tpages></addata></record> |
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| ispartof | Journal of orthopaedic trauma, 1994-08, Vol.8 (4), p.300-309 |
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| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Animals Bone Nails Capillary Permeability Contusions - complications Disease Models, Animal Embolism, Fat - blood Embolism, Fat - classification Embolism, Fat - diagnosis Embolism, Fat - etiology Embolism, Fat - physiopathology Equipment Design Female Femoral Fractures - complications Femoral Fractures - surgery Fracture Fixation, Intramedullary - adverse effects Fracture Fixation, Intramedullary - instrumentation Lung Injury Multiple Trauma - complications Multiple Trauma - surgery Pulmonary Circulation Pulmonary Embolism - blood Pulmonary Embolism - classification Pulmonary Embolism - diagnosis Pulmonary Embolism - etiology Pulmonary Embolism - physiopathology Severity of Illness Index Sheep Shock, Hemorrhagic - complications Thromboxane B2 - analogs & derivatives Thromboxane B2 - blood Triglycerides - blood |
| title | Does the Reamer Type Influence the Degree of Lung Dysfunction After Femoral Nailing Following Severe Trauma? An Animal Study |
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