The Relationship between Plasma Levels of Interleukin-6, Multiple Organ Dysfunction and Mortality in Orthopedic Patients.

BACKGROUND: Interleukin 6 (IL-6) functions as both a pro-inflammatory cytokine and an anti-inflammatory cytokine. OBJECTIVE: To evaluate the levels of IL-6 in patients with multiple organ dysfunction syndrome (MODS). METHODS: Level of IL-6 was assessed and recorded for 14 days subsequent to the injury in 161 multiple trauma patients. MODS were diagnosed using Marshal Score. Injury Severity Scoring (ISS) was measured for all patients. RESULTS: The results of this study indicated that there was a significant relationship between the level of IL-6 and ISS on the first and second days post trauma (P=0.0001). The high level of IL-6 on the second day post trauma was associated with high mortality rate. CONCLUSION: Our study suggests the second day as the golden time for measuring the serum levels of IL-6. These findings warn us to take more health care actions in patients with higher serum levels of IL-6 on the second day.

Distal clavicular fracture treatment with suture anchor method.

OBJECTIVE: The aim of this study was to evaluate the results of the suture anchor fixation in the treatment of distal clavicle fractures. METHODS: This cross series study included 43 patients (27 males, 12 females; mean age: 40.1±10.18 years) with type II unstable distal clavicle fractures. The fractures were fixed by 2 pins and 1 suture anchor. All patients were followed at postoperative months 3, 6, and 12 and underwent clinical and radiographic evaluation after 1 year, ongoing at 6-month intervals thereafter. Demographic data were recorded on the first postoperative day. At third and 12th month follow-up, Constant-Murley Shoulder Outcome Score (CMS) was used to assess performance of the acromioclavicular joint, and Visual Analog Scale questionnaire was used to assess patient satisfaction. RESULTS: Based on CMS scores 1 year after surgery, 37 patients were in excellent condition, and 2 patients were in good condition. Mean surgical case duration was 43.25±4.01 min. These results indicate that there was no significant association between CMS scores and surgical case duration. Mean time to union in our patients was 4.46±0.96 months. CONCLUSION: We were able to observe optimal results in our patients by using closed reduction and suture anchors without opening the fracture site, thus allowing physiological processes in union without complications of complete union, while also preventing additional costs such as removing the device.