C-reactive protein (CRP) as an indicator of sepsis in orthopaedic trauma

In the present study serial estimations of changes in plasma C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total leucocyte count (TLC) and temperature were recorded in 100 patients. Nature and extent of tissue trauma varied from fresh soft tissue or bony injuries to elective orthopaedic procedures, besides acute orthopaedic infections. All the parameters showed a rise from day 1-3 from the normal levels, though the rise in temperature was minimal. However, from third day onwards, CRP level showed a sharp decline in all cases without any septic complication or infective patients who improved with treatment. Decline of ESR levels on the other hand was variable. Similarly, decline of TLC and temperature was also not consistent and sharp. Persistent rise of CRP level beyond third day or any subsequent rise in CRP level was consistent with a septic complication in the patient. CRP was therefore observed to be a sensitive and dependable indicator of orthopaedic sepsis even orthopaedic trauma.