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Hematoma-induced febrile response in the pediatric patient
Insights
Children
Area of Science:
- Pediatric Orthopedics
- Physiology
- Biomedical Research
Background:
- Post-operative and post-traumatic fever is common in children with long bone injuries.
- The cause of this fever is often unclear, but blood resorption is a suspected factor.
Purpose of the Study:
- To investigate whether blood resorption following long bone trauma or surgery causes fever in children.
- To explore the relationship between hematoma formation and temperature elevation.
Main Methods:
- Clinical retrospective review of pediatric patients with closed femoral or tibial fractures who developed fever (≥101°F).
- Laboratory animal study involving creating hematomas in rabbits via intramuscular blood reinjection.
- Control groups in the animal study received no blood reinjection or lactated Ringer's solution.
Main Results:
- Pediatric patients with fractures showed significant temperature elevation.
- Rabbits with induced hematomas developed notable fever.
- Younger rabbits exhibited a more pronounced temperature increase after blood injection.
Conclusions:
- Blood resorption from hematomas, particularly in long bone injuries, is a likely cause of fever in children.
- Age appears to be a factor in the intensity of the fever response to blood resorption.
Abstract:
Frequently there is a temperature elevation in children following operative procedures or trauma involving the long bones. A combined clinical and laboratory study investigated the possibility that this was secondary to blood resorption. A clinical study was conducted by reviewing the records of all children admitted to the hospital over a 10-year period with closed femoral or tibial fractures. All these patients demonstrated a temperature elevation to at least 101 degrees F. In the laboratory study, rabbits of different ages were bled, and this blood was reinjected into their quadriceps muscle to create hematomas. Control rabbits were hemorrhaged and either were not reinjected with their blood or were injected intramuscularly with lactated Ringer's solution. Those rabbits that received the intramuscular blood injections developed significant temperature elevations, and the younger the rabbit the more pronounced the temperature rise.