Proteomics after ankle-joint-fractures

After severe trauma serious haemorrhage, severe head trauma and multiple organ
failure are still the most important causes of death. Especially in patients
with a combination of severe haemorrhage or head trauma and extremity-lesions
the question of optimal timing of the operation as well as the choice of type
of fracture stabilization is still un-answered. The key-point in this issue is
the amount of trauma-load of a patient and the possibility to tolerate a
*second-hit* like operations. The search for prognostic and determinant factors
for estimating outcome of a trauma-victim in the last years was very intensive.
The complexity of the systemic acute phase reaction to trauma might be the
reason why *the golden bullet* couldn*t be found yet. Proteomics might be a
tool to answer these unsolved questions.

The following questions will be answered:
• Can typical protein-profiles in a proteomic-assay be identified after trauma,
which might be correlated with the outcome of the patients?
• How is the dynamic of protein-profile-changes in the proteomics-essay in the
healing-process?

We will include all adult patients with an isolated ankle-fracture.
Exclusion-criteria*s beside age are relevant co-morbidities and defeating of
the study. So we want to include patients with an ASA-classification of 1 or 2.
We want to include 20 patients.
For getting a good dynamic of the protein-profiles a continuous collecting of
blood-samples is extremely important.
The following time points for blood-sampling are planned:
Day 0 (day of trauma)
Day 1, 3, 5, 7, 14, 21, 28, 3 months.
All samples will be taken round about 11 o*clock.
The blood-samples are taken immediately to the CHIC (surgical intensive care)
were centrifuge is available. By a temperature of 4°C and with 2500 rpm the
test tubes will be centrifuged for 10 minutes. Afterwards the serum will be
divided in several eppendorff-tubes and placed in the freezer by -70°C. All
tubes will be marked following the prepared code-numbers. The first character
of the code represents the patient-number and the second the number of the
probe.

The proteomics are measured by the Groninger proteomics-lab. The results will
be correlated with the outcome and healing process of the patients.
Therefore the information*s of the patient-dossier are needed.

Very low risk for the patients. There is only a punctering of the cubital vein
necessary.