The Impact of Intramedullary Nailing of Tibia XXXX on the Innate Immune System.

@entity1 @entity32 @entity650 @entity174 @entity649 @entity9536 @entity130
INTRODUCTION: @entity32 after @entity130 is thought to be aggravated by intramedullary nailing (IMN) and predisposes to acute @entity649 . Polymorphonuclear granulocytes (PMNs) are the main effector cells in this process. However, in @entity1 with a femur @entity174 , the injury severity was the decisive factor for the PMN phenotype. A tibia @entity174 is often caused by a more moderate injury and might allow for a window to assess the innate immune response caused by IMN. METHODS: A consecutive series of @entity1 with a tibia @entity174 were included. The innate immune response was measured before and after IMN by plasma @entity650 , PMN @entity9536 , and active FcyRII (FcyRII*) expression both before and after fMLF (N-formylmethionyl-leucyl-phenylalanine) stimulation. Furthermore, HLA-DR on monocytes was analyzed. RESULTS: Twenty-five consecutive @entity1 were included. Polymorphonuclear granulocyte fMLF-induced @entity9536 and FcyRII* were decreased. In concordance, HLA-DR expression on monocytes was decreased in @entity1 compared with control subjects. Intramedullary nailing was associated with a further decrease of HLA-DR-positive monocytes, whereas no changes in PMN phenotype or plasma @entity650 levels were observed. CONCLUSION: Intramedullary nailing of a @entity174 did not affect the PMN phenotype. The impact from injury determined the PMN phenotype. In contrast, the monocyte phenotype changed after the additional insult by IMN in @entity1 with an isolated @entity174 .
