The System Evaluation Of The Correlation According To The Infection Of Lower Limb Nonunion With The Increased Concentration Of Erythrocyte Sedimentation Rate And C-reactive Protein

Objective: To investigate the relationship between the increased concentration of ESR and CRP with infection in the bone nonunion of lower limb.Method: 37 patients with bone nonunion of lower limb who were treated in the department of traumatic orthopedic of our hospital from January 2014 to January 2017 were chosen as the research object.According to the infection,the patients were divided into group A(uninfected group)and group B(infected group).At the time of admission,The information of ESR,CRP,PCT,WBC,neutrophil count,the narrowing marrow cavity in X-ray,and local tenderness,activity,local pus ulceration of the nonunion were collected,and both groups were followed up so as to find out the operation time and the hospital readmission of the previous fracture surgery.The statistical analysis was performed with the use of SPSS19 software.Results: In terms of the use of t test index,ESR(t=1.402,P=0.181),CRP(t=0.753,P=0.457),WBC(t=1.164,P=0.274)and neutrophil counts(t=1.158,P=0.274)in group A was higher than group B,however there isno statistical difference.Both two groups were followed up,the operation time(t=0.157,P=0.877)in group A is slightly longer than group B,but there is no statistical difference.The hospital readmission of the previous fracture surgery(t=-1.658,P=0.119)in group B is longer than that in group A,however there is no significant difference either.In terms of the use of?2 test index,there is no significant difference in PCT(P=1.000),WBC(P=1.000),neutrophil counts(P=1.000)and local tenderness(P=0.262),activity(P=1.000)of nonunion.However,the occurrence rate of group B was significantly higher than group A during to the local pus ulceration(P=0.000)and the narrowing marrow cavity in X-ray(P=0.036),there was statistical difference.The sensitivity,specificity and positive predictive value of ESR in this sample are 46.67%,50%,38.89%,the sensitivity,specificity and positive predictive value of CRP are86.67%,4.55%,38.24%,the sensitivity,specificity and positive predictive value of WBC are 26.67%,68.18%,36.36%.Conclusion: there is no exact correlation between the increased concentration of ESR,C reactive protein and infection of bone nonunion of lower limb.In this study,40.5%(15/37)of the patients really acquired infection,however there are nearly 60% patients who could be treated with surgery related to bone nonunion without anti infection treatment.This can not only reduce the patient's hospital readmission,so as the economic burden of patients,but also having a great benefit for therational use of medical resources.Blood sedimentation,C-reactive protein(high sensitivity)can be advanced in early screening to judge the infection.It is advantageous to detect and treat the infection early.Further inspection is needed if necessary(blood culture).The risk of infection in patients improve greatly,if the local pus ulceration and the narrowing marrow cavity in X-ray appeared.It is necessary to advance the anti-infection treatment first.