Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2015 Jan 14;20(1):5.
doi: 10.1186/s40001-014-0079-z.

Plate osteosynthesis versus hemiarthroplasty in proximal humerus fractures--does routine screening of systemic inflammatory biomarkers makes sense?

Klemens Horst  1 , Frank Hildebrand  2 , Roman Pfeifer  3 , Karin Köppen  4 , Philipp Lichte  5 , Hans-Christoph Pape  6 , Thomas Dienstknecht  7
Affiliations
Comparative Study

Plate osteosynthesis versus hemiarthroplasty in proximal humerus fractures--does routine screening of systemic inflammatory biomarkers makes sense?

Klemens Horst et al. Eur J Med Res. .

Abstract

Background: Increases in C-reactive protein (CRP) and white blood cell (WBC) counts after orthopedic surgical procedures can give evidence of postoperative infection. However, there is a lack of knowledge about the kinetics of these biomarkers in cases with an uneventful clinical course after osteosynthesis of upper limb fractures. This study investigated CRP and WBC serum levels after osteosynthesis or hemiarthroplasty of humeral head fractures.

Methods: A retrospective study on patients with humeral head fractures who had open reduction and internal fixation via plate osteosynthesis (PO) (n = 64) or hemiarthroplasty (HA) (n = 28) without any complications in the postoperative clinical course. C-reactive protein serum levels (mg/l) and leukocyte counts (g/l) were assayed at several time points. Multiple regression analysis was performed to evaluate the influence of several confounding variables (the surgical procedure, duration of surgery, patient's health status, and comorbidities) on the kinetics of CRP and WBC.

Results: Our data showed that CRP levels were statistically significantly higher in the HA cohort when compared to the PO cohort (p = 0.003). Moreover, daily measurement of CRP levels during the postoperative course showed that CRP peaked on the 2nd and 3rd days postoperatively in both cohorts and started to decrease afterward, reaching normal values on day 8 to 10. However, WBCs did not show any significant differences between the HA and PO cohorts. Finally, the choice of surgical procedure and the patient's health status were associated with higher peak levels of CRP.

Conclusions: After osteosynthesis or hemiarthroplasty of humeral head fractures, CRP is a responsive serum parameter in the postoperative course of an uneventful inflammatory response. Abnormalities from these values should be interpreted carefully as they may give a hint as to postoperative complications such as infection.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kinetics of postoperative CRP levels after plate osteosynthesis (PO) vs. hemiarthroplasty (HA), *p < 0.05 on days 1, 2–3 and 4–5.
Figure 2
Figure 2
Kinetics of postoperative WBC levels: plate osteosynthesis (PO) vs. hemiarthroplasty (HA).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Palvanen M, Kannus P, Niemi S, Parkkari J. Update in the epidemiology of proximal humeral fractures. Clin Orthop Relat Res. 2006;442:87–92. doi: 10.1097/01.blo.0000194672.79634.78. - DOI - PubMed
    1. Kim SH, Szabo RM, Marder RA. Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008. Arthritis Care Res (Hoboken) 2012;64(3):407–14. doi: 10.1002/acr.21563. - DOI - PubMed
    1. Tepass A, Rolauffs B, Weise K, Bahrs SD, Dietz K, Bahrs C. Complication rates and outcomes stratified by treatment modalities in proximal humeral fractures: a systematic literature review from 1970–2009. Patient Saf Surg. 2013;7(1):34. doi: 10.1186/1754-9493-7-34. - DOI - PMC - PubMed
    1. Roux A, Decroocq L, El Batti S, Bonnevialle N, Moineau G, Trojani C, et al. Epidemiology of proximal humerus fractures managed in a trauma center. Orthop Traumatol Surg Res. 2012;98(6):715–9. doi: 10.1016/j.otsr.2012.05.013. - DOI - PubMed
    1. Jaeger M, Izadpanah K, Maier D, Reising K, Strohm PC, Sudkamp NP. Fractures of the humerus head. Chirurg. 2012;83(3):285–94. doi: 10.1007/s00104-011-2262-x. - DOI - PubMed

Publication types