Effects of reamed intramedullary nailing on altered body temperature, CRP and plasma lactate

Abstract

Congenital metabolic disorders include type I glycogen storage disease. Examples of drugs/toxins which give rise to elevated lactate are methanol, ethanol, epinephrine and acetaminophen. L-lactate levels in CSF will generally mirror those in blood/plasma. However, increased lactate levels in CSF in the absence of increased blood/plasma lactate concentration have been reported in cases of bacterial meningitis, cerebral hypoxia, ischemia and in certain inborn errors of metabolism e.g. pyruvate dehydrogenase deficiency, mitochondrial myopathies and biotinidase deficiency. Patients with additional injuries or pre-existing known severe pathologic problem (such as malignancy, active infectious disease, rheumatoid disease) were excluded from the study. Fourty patients (32 males; 8 females; mean age, 43.1 (range, 20–97) years) who sustained isolated closed diaphyseal fracture of the femur or the tibia remained in the study group. All femoral fractures and tibial fractures were treated with an interlocking nail, with reamed technique. The value of plasma lactate pre operatively was 15.3. On the 1st POD, the mean value was 14.8 (p = 0.849), and on the 3rd POD it was 14.3. And on the 10th POD plasma lactate value was 15.3 in the control group almost similar to the preoperative mean value.