The level of the tumor necrosis factor in patients with femoral neck fractures

Methods: We have investigated the dynamics of the TNF level in patients with femoral neck osteoporotic fractures. The main group of 132 patients aged 60–75 with fractures of the proximal section of the neck of femur and the controlling group of 78 patients of the same age without the fracture were the object of our investigation.

Results: In assessing the TNF-a serum level in patients with femoral neck osteoporotic fractures we revealed its trustworthy growth. In the group of patients with femoral neck osteoporotic fractures we observed a sharp increase of TNF-a concentration (93,8 ± 5,9 pg/ml) which exceeded the indices of the controlling group of patients by 3,4 times (r < 0,5). The investigation of the TNF-a serum level before the operation in patients with femoral neck osteoporotic fractures according to the type of the fracture in comparison with the controlling group made it possible to state that the content of this cytokine in all the patients was heightened. The highest indices were recorded in patients with subcapital femoral neck fractures.

Conclusions: We have revealed high rates of TNF-a in patients with femoral neck osteoporotic fractures which exceeded the indices of the controlling group of patients by 3,4 times (r < 0,5). Moreover, during the first 24 hours after the operation a higher level was found in the group of patients with subcapital and pertrochanteric femoral neck fractures. Later, on the 14-th day after the operation, we observed the tendency to reduction of the TNF-a rate by 1,4 and 2,1 times, accordingly. On the contrary, in patients with spit and transcervical fractures the TNF-a level reduced during the first 24 hours, but there was a tendency to augmentation on the 14-th day by 0,8 and 0,7 times, accordingly. The obtained data can serve as a prognostic criterion of the emergence of postoperative complications and the course of treatment.