DOES THE REAMER TYPE INFLUENCE THE DEGREE OF LUNG DYSFUNCTION AFTER FEMORAL NAILING FOLLOWING SEVERE TRAUMA - AN ANIMAL STUDY

被引：78

作者：

PAPE, HC

DWENGER, A

GROTZ, M

KAEVER, V

NEGATSCH, R

KLEEMANN, W

REGEL, G

STURM, JA

TSCHERNE, H

机构：

[1] Departments of Trauma Surgery, Hannover Medical School, Hannover

[2] Departments of Clinical Biochemistry, Hannover Medical School, Hannover

[3] Departments of Molecular Pharmacology, Hannover Medical School, Hannover

[4] Forensic Medicine, Hannover Medical School, Hannover

来源：

JOURNAL OF ORTHOPAEDIC TRAUMA | 1994年 / 8卷 / 04期

关键词：

INTRAMEDULLARY FEMORAL NAILING; LUNG CONTUSION; ACUTE RESPIRATORY DISTRESS SYNDROME; PULMONARY COMPLICATIONS; HEMORRHAGIC SHOCK;

D O I：

10.1097/00005131-199408000-00005

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

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 reamers: group 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-TXB, 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.

引用

页码：300 / 309

页数：10

共 48 条

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