Department of Orthopedic Surgery, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, 25, Simgok-ro 100beon-gil, Seo-gu, Incheon, 22711, South Korea.
Department of Radiology, Severance Health Check-up, 10, Tongil-ro, Jung-gu, Seoul, Republic of Korea.
BMC Musculoskelet Disord. 2022 Dec 20;23(1):1110. doi: 10.1186/s12891-022-06063-5.
Traumatic brain injury (TBI) has been known to accelerate bone healing. Many cells and molecules have been investigated but the exact mechanism is still unknown. The neuroinflammatory state of TBI has been reported recently. We aimed to investigate the effect of TBI on fracture healing in patients with tibia fractures and assess whether the factors associated with hematoma formation changed more significantly in the laboratory tests in the fractures accompanied with TBI.
We retrospectively investigated patients who were surgically treated for tibia fractures and who showed secondary bone healing. Patients with and without TBI were divided for comparative analyses. Radiological parameters were time to callus formation and the largest callus ratio during follow-up. Preoperative levels of complete blood count and chemical battery on admission were measured in all patients. Subgroup division regarding age, gender, open fracture, concomitant fracture and severity of TBI were compared.
We included 48 patients with a mean age of 44.9 (range, 17-78), of whom 35 patients (72.9%) were male. There were 12 patients with TBI (Group 1) and 36 patients without TBI (Group 2). Group 1 showed shorter time to callus formation (P < 0.001), thicker callus ratio (P = 0.015), leukocytosis and lymphocytosis (P ≤ 0.028), and lower red blood cell counts (RBCs), hemoglobin, and hematocrit (P < 0.001). Aging and severity of TBI were correlated with time to callus formation and callus ratio (P ≤ 0.003) while gender, open fracture, and concomitant fracture were unremarkable.
Tibia fractures with TBI showed accelerated bone healing and superior measurements associated with hematoma formation (lymphocytes, RBCs, hemoglobin, hematocrit). Promoted fracture healing in TBI was correlated with the enhanced proinflammatory state.
III, case control study.
外伤性脑损伤 (TBI) 已被证实可加速骨愈合。许多细胞和分子已被研究，但确切的机制仍不清楚。最近报道了 TBI 的神经炎症状态。我们旨在研究 TBI 对伴有胫骨骨折患者骨折愈合的影响，并评估在伴有 TBI 的骨折中，与血肿形成相关的因素在实验室检查中是否变化更明显。
我们回顾性调查了接受手术治疗且出现继发性骨愈合的胫骨骨折患者。将有和无 TBI 的患者分为两组进行对比分析。影像学参数为骨痂形成时间和随访过程中最大骨痂比。所有患者入院时均测量全血细胞计数和化学电池的术前水平。亚组按年龄、性别、开放性骨折、合并骨折和 TBI 严重程度进行分组比较。
我们纳入了 48 例平均年龄为 44.9 岁（范围为 17-78 岁）的患者，其中 35 例（72.9%）为男性。12 例患者有 TBI（第 1 组），36 例患者无 TBI（第 2 组）。第 1 组的骨痂形成时间更短（P<0.001），骨痂比更厚（P=0.015），白细胞增多和淋巴细胞增多（P≤0.028），红细胞计数（RBCs）、血红蛋白和血细胞比容更低（P<0.001）。年龄和 TBI 的严重程度与骨痂形成时间和骨痂比相关（P≤0.003），而性别、开放性骨折和合并骨折则无明显相关性。
伴有 TBI 的胫骨骨折表现出加速的骨愈合和与血肿形成相关的更优测量值（淋巴细胞、RBCs、血红蛋白、血细胞比容）。TBI 促进骨折愈合与增强的促炎状态相关。
III 级，病例对照研究。
