The early response to major trauma and intramedullary nailing

T O White, R E Clutton, Donald Salter, D Swann, J Christie, C M Robinson

Research output: Contribution to journalArticlepeer-review


The stress response to trauma is the summation of the physiological response to the injury (the 'first hit') and by the response to any on-going physiological disturbance or subsequent trauma surgery (the 'second hit'). Our animal model was developed in order to allow the study of each of these components of the stress response to major trauma. High-energy, comminuted fracture of the long bones and severe soft-tissue injuries in this model resulted in a significant tropotropic (depressor) cardiovascular response, transcardiac embolism of medullary contents and activation of the coagulation system. Subsequent stabilisation of the fractures using intramedullary nails did not significantly exacerbate any of these responses.

Original languageEnglish
Pages (from-to)823-7
Number of pages5
JournalJournal of Bone and Joint Surgery, British Volume
Issue number6
Publication statusPublished - Jun 2006


  • Animals
  • Blood Coagulation
  • Bone Nails
  • Disease Models, Animal
  • Embolism
  • Femoral Fractures
  • Fracture Fixation, Intramedullary
  • Fractures, Comminuted
  • Hemodynamics
  • Sheep
  • Soft Tissue Injuries
  • Stress, Physiological
  • Tibial Fractures
  • Wounds and Injuries


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