Eurasian Journal of Chemical, Medicinal and Petroleum Research

Abstract Introduction: Femoral implant surgery is frequently complicated by early inflammatory reactions that may be difficult to distinguish from normal postoperative responses. Because C-reactive protein reflects systemic inflammatory activity, preoperative measurement may help identify patients at greater risk of acute pathologic inflammation after surgery. The aim of this study was to evaluate the diagnostic value of preoperative CRP in predicting acute inflammation following femoral implant placement.

Material and methods: This descriptive cross-sectional study was conducted at Shahid Madani Hospital in Tabriz, Iran. Using Cochran’s formula, the sample size was estimated at 73 patients, who were enrolled through convenience sampling. Data were extracted from medical records on demographic characteristics, comorbidities, preoperative CRP and other laboratory findings, operative details, and early postoperative inflammatory outcomes to assess the diagnostic value of preoperative CRP.

Results: Among 73 patients, acute postoperative inflammation occurred in 21.9%. Affected patients had higher preoperative CRP (24.18 vs 12.32 mg/L, P < 0.001), ESR (34.50 vs 25.98 mm/h, P = 0.009), and WBC (9.96 vs 8.40 x10³/muL, P = 0.015), but lower hemoglobin (11.28 vs 12.34 g/dL, P = 0.021) and albumin (3.29 vs 3.70 g/dL, P = 0.003). CRP showed good diagnostic performance (AUC = 0.812, sensitivity 78.9%, specificity 73.6%, NPV 95.1%).

Conclusion: Preoperative CRP appears to be a clinically useful marker for identifying patients at risk of acute inflammation after femoral implant placement. Its strong discriminatory capacity and high negative predictive value suggest particular value in perioperative risk stratification, especially when interpreted alongside comorbidity burden, nutritional status, and operative complexity.

Abstract Introduction: Early infection after femoral implant placement is a serious complication influenced by host immunity, wound healing capacity, and nutritional-inflammatory status. Preoperative serum albumin is a practical biomarker that may reflect vulnerability to postoperative infection, but its predictive accuracy remains uncertain in femoral implant surgery. This study aimed to evaluate the sensitivity and specificity of preoperative serum albumin in predicting early infection after femoral implant placement.

Material and methods: This retrospective descriptive cross-sectional study was conducted at Shahid Madani Hospital, Tabriz, on 125 patients selected by convenience sampling. The sample size was estimated using Cochran’s formula. Data were extracted from medical records to evaluate preoperative serum albumin, demographic and clinical variables, operative characteristics, and early postoperative infection after femoral implant placement, with the aim of assessing the diagnostic performance of albumin in predicting early infection.

Results: Among 125 patients, early postoperative infection occurred in 15.2% (19/125). Infected patients had lower preoperative albumin (3.12 ± 0.46 vs 3.66 ± 0.51 g/dL; P < 0.001), a higher rate of hypoalbuminemia (63.2% vs 27.4%; P = 0.002), lower hemoglobin (P = 0.011), and higher inflammatory markers (WBC, P = 0.018; CRP, P = 0.006). Serum albumin predicted infection with good accuracy (cutoff 3.35 g/dL; sensitivity 78.9%, specificity 73.6%, AUC 0.812, P < 0.001).

Conclusion: Preoperative serum albumin appears to be a clinically useful marker for identifying patients at increased risk of early infection after femoral implant placement. Lower albumin levels were consistently associated with infection and showed acceptable diagnostic performance. These findings support incorporating serum albumin into routine preoperative assessment to improve risk stratification and guide perioperative optimization in this surgical population.

Abstract Introduction: Femoral fracture surgery in elderly patients is frequently followed by substantial acute postoperative pain, which may be influenced not only by surgical trauma but also by systemic inflammatory and immune responses. Because the Systemic Immune-Inflammation Index may reflect this biological susceptibility, the present study aimed to pathologically assess its association with the severity of acute postoperative pain after femoral fracture surgery.

Material and methods: This descriptive cross-sectional study was conducted at Shahid Madani Hospital, Tabriz, on 93 elderly patients selected by convenience sampling, with sample size estimated using Cochran’s formula. Demographic, clinical, laboratory, surgical, and postoperative pain data were collected. The Systemic Immune-Inflammation Index was calculated from preoperative platelet, neutrophil, and lymphocyte counts, and its association with acute postoperative pain severity was statistically evaluated.

Results: Patients with severe postoperative pain had markedly higher preoperative SII than those with moderate or mild pain (1801.2±789.6 vs 1280.5±542.7 and 850.2±386.4; P<0.001), along with higher inflammatory markers, lower hemoglobin and albumin, longer operations, greater blood loss, more opioid use, delayed mobilization, and longer hospitalization (all P<0.05). SII correlated with pain intensity (highest 24-hour NRS: r=0.574, P<0.001) and independently predicted severe pain (OR=2.86, 95% CI 1.54-5.31), with good accuracy (AUC=0.812).

Conclusion: Preoperative SII appears to be a clinically useful biomarker for identifying patients at increased risk of severe acute postoperative pain. Its independent association with pain severity and acceptable diagnostic performance suggest that SII may support early perioperative risk stratification and help guide individualized analgesic planning, particularly in patients with an elevated inflammatory burden before surgery.

Abstract Introduction: Scaphoid waist nonunion with avascular necrosis is a difficult reconstructive problem because impaired blood supply, instability, and deformity can compromise healing and function. Vascularized grafting has therefore emerged as a biologically appealing option to improve union in selected patients. The aim of this study was to evaluate the early outcomes of the Mathoulin technique in scaphoid waist nonunion with avascular necrosis.

Material and methods: This descriptive cross-sectional study was conducted at Shahid Madani Hospital, Tabriz, with a convenience sample of 50 eligible patients selected using the standard descriptive sample-size formula. Patients underwent evaluation and treatment with the Mathoulin technique, and demographic, clinical, radiographic, and early postoperative outcome variables were recorded to assess short-term surgical results.

Results: The cohort comprised 50 patients (mean age 34.8±9.6 years), predominantly men (64.0%), with avascular necrosis in all cases and a mean nonunion duration of 15.2±6.4 months. After the Mathoulin technique, pain, wrist motion, and grip strength improved significantly (VAS 6.9±1.2 to 2.1 1.0; flexion 41.3±8.7° to 55.6±7.9°; grip strength 19.4±5.3 to 28.7±6.1 kg; all P<0.001), and union was achieved in 88.0% of patients at 11.8±2.6 weeks. Smoking, prior surgery, longer nonunion, severe AVN, and humpback deformity were associated with poorer outcomes.

Conclusion: The Mathoulin technique provided encouraging early clinical and radiographic results for scaphoid waist nonunion with avascular necrosis, with high union rates and significant functional improvement. Outcomes were less favorable in patients with smoking, prior surgery, prolonged nonunion, severe AVN, or deformity, suggesting that careful patient selection remains important.

Abstract Introduction: Pediatric complete forearm fractures may redisplace after closed reduction, potentially causing functional impairment and requiring repeat intervention. Although long-arm and sugar-tong splints can restrict motion and accommodate swelling, the effectiveness of their combined use remains uncertain. This study aimed to evaluate the effect of combined sugar-tong and long-arm splinting on fracture displacement in children with complete forearm fractures.

Material and methods: This randomized clinical trial at Shohada Hospital, Tabriz, evaluated 50 children with complete forearm fractures requiring closed reduction (25 per group, calculated via the two-independent-means formula). Participants were randomly assigned to combined sugar-tong and long-arm splinting or standard long-arm splinting alone. Serial radiographs were obtained from post-reduction through early follow-up to evaluate changes in fracture angulation and translation between the two immobilization methods.

Results: The combined splint group maintained better alignment than the standard splint group, with lower AP angulation, lateral angulation, translation, and shortening at follow-up (week 1 and 2, all P≤0.001); it also had fewer losses of reduction (8.0% vs. 36.0%,P=0.014) and remanipulations (4.0% vs. 24.0%, P=0.037), while parental satisfaction was higher (8.6±1.1 vs. 6.8±1.5, P<0.001).

Conclusion: Combined sugar-tong and long-arm splinting was more effective than standard splinting in preserving reduction and preventing secondary displacement in children with complete forearm fractures, without increasing complications. This simple immobilization strategy may improve early fracture stability and reduce the need for repeat intervention.

Abstract Introduction: Tibial fractures present substantial healing challenges because limited soft-tissue coverage, vulnerable blood supply, fracture complexity, and host-related factors increase the risk of impaired union. Although plate fixation restores alignment and stability, it may contribute to infection, nonunion, malunion, and implant-related complications. This study aimed to evaluate healing time and complications following tibial fracture plating from a pathologic perspective.

Material and methods: This descriptive cross-sectional study included 52 patients who underwent plate fixation for tibial fractures at Shahid Madani Hospital, Tabriz, selected through convenience sampling. Demographic, clinical, fracture-related, laboratory, operative, and postoperative data were collected from medical records and follow-up assessments. Healing time was determined using clinical and radiographic evidence of union, while postoperative complications, including infection, impaired union, malalignment, and implant-related failure, were documented.

Results: Patients with postoperative complications were older and had more severe injuries, including higher rates of open and comminuted fractures, longer time to surgery, and worse preoperative inflammatory and nutritional profiles (all significant variables, P<0.05). Healing time was markedly prolonged in complicated cases (23.2 ± 4.6 vs 15.9 ± 3.2 weeks, P<0.001). Independent predictors included age (OR=1.04), open fracture (OR=2.86), CRP (OR=1.17), surgical delay (OR=1.38), and operative duration (OR=1.21).

Conclusion: These findings indicate that postoperative complications after tibial plate fixation are driven by both fracture severity and adverse preoperative biological status. Early surgical management, control of inflammation, and optimization of hemoglobin and albumin levels may improve healing and reduce complication risk. Preoperative CRP and operative burden appear particularly valuable for risk stratification and perioperative decision-making.