Abstract

Objective

To evaluate whether serial clinical and laboratory assessment may help define a safer timing for osteosynthesis of lower-limb long bone fractures and decrease postoperative infectious complications.
 

Materials and Methods

Data from 110 injured patients treated at City Medical Center No. 3 and the State institute “Health Complex Istiqlol” between 2016 and 2024 were analyzed. The control group consisted of 59 patients, while the study group comprised 51 patients. In the study group, decisions regarding the timing of surgery were based not only on the clinical presentation but also on changes in procalcitonin (PCT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and leukocyte count.
 

Results

The most notable laboratory response to mechanical trauma occurred during the early post-traumatic period. CRP levels frequently remained elevated during the first 24 hours and at the 7-day follow-up mark. The ESR increased primarily from the second day onwards, with a secondary rise observed on days 7–10 following surgical fixation. In cases of isolated injury, leukocytosis typically developed on the second or third day, whereas in polytrauma complicated by blood loss, shock, and multiple organ dysfunction, it appeared within the first 24 hours.
 

Conclusion

 Early changes in inflammatory markers reflect the severity of traumatic disease and may clarify the risk of postoperative infection. In patients with lower-limb long bone fractures, preoperative preparation and osteosynthesis timing should be individualized according to the patient’s clinical course and laboratory trends.
 

Keywords

inflammation infection complications osteosynthesis inflammatory markers trauma.

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