Early Immunologic Precision Typing At-Risk Fractures to Predict Nonunion
Abstract
Traumatic events like car accidents and combat can cause severe injuries to the leg, including the bones and surrounding tissue. These injuries are especially common among service members, accounting for over half of all combat casualties. Most people who receive appropriate medical care go on to heal, but some are left permanently disabled. In fact, hundreds of thousands of Americans develop a condition called a nonunion, failed healing of a long bone, every year. In addition to causing pain and disability, a nonunion is a tremendous financial burden, estimated at 500,000 USD lifetime cost. It can take months for a doctor to determine, usually by an x-ray, that their patient isn’t healing properly. By this time, the patient has already suffered a long, painful treatment process. At best, they will need further surgeries, and at worst, the window of opportunity to try new treatments has passed and they will need amputation. Doctors and scientists have known for a long time that a serious injury causes the body to go through a process called inflammation, which is a spike in certain cells and molecules in the blood. In the short term, these cells and molecules help prevent infection, stimulate blood flow, and promote other functions that can be beneficial for healing. Usually, inflammation caused by injury resolves without causing long-term problems, but sometimes it can persist for a long time and lead to an imbalance in the immune system. Only recently have doctors and scientists begun to study the role that an imbalanced immune system can play in impairing bone healing. We measured cells and molecules in the blood of rats that had a severe bone injury and found that we could predict with high accuracy whether they would heal. We want to try this same approach in human patients. We are planning to measure 7 types of cells and 1,500 molecules in the blood of patients with a serious leg injury, an open tibia fracture. We will take blood at the time of injury and at four follow-up appointments and record whether the patients go on to heal. Using the levels of cells and molecules measured in the blood as early as 2 weeks after injury, we will try to predict whether a patient heals from their injury. If we succeed, it will allow doctors to simply take a blood draw a couple weeks after injury and measure a few key cells and molecules to monitor healing, rather than waiting many months to take an x-ray. This will allow them to intervene early, when healing is still possible, preventing a long and painful treatment course and restoring function to a patient’s injured leg.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310928
Entities
People
- Todd O McKinley
Organizations
- Indiana University
- United States Army