The C-reactive protein (CRP) in patients with long bone fractures and after arthroplasty

Between March 1991 and February 1992 serial serum C-reactive protein (CRP) levels were measured prospectively for three weeks in 57 consecutive patients with fractures of long bones, and also in 11 patients who had undergone primary total hip or knee arthroplasty. A semi-quantitative capillary floculation method was used for measuring the CRP level. The highest values were usually recorded 2-3 days after trauma or operation, and the CRP was nearly normal by three weeks. In the patients with long bone fractures the amplitude of CRP response was affected by the type of treatment. Lower values were observed in those patients treated conservatively than in those who underwent operation, but the profile of CRP response was similar, regardless of the type of treatment. The CRP response was also affected by the severity of the trauma in conservatively treated patients, but in those who underwent operation the CRP response was similar, regardless of the severity of the injury. In patients with primary total hip or knee arthroplasty the pattern of CRP response after operation was similar to that in the patients with long bone fractures who underwent surgical treatment. Awareness of the natural course of the CRP response after fracture and arthroplasty may help in the diagnosis of early post-traumatic and postoperative complications, especially infections.