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J Korean Soc Traumatol. 2009 Dec;22(2):123-127. Korean. Original Article.
Park TW , Lee DH , Lee SJ , Kim SE , Kim CW .
Department of Emergency Medicine, College of Medicine, Chung-Ang University, Korea.

PURPOSE: There is an increasing amount of evidence that S100B could function as a marker of brain damage. However, the cerebral specificity of S100B has been questioned, so the extracerebral sources of S100B have been paid attention. We performed this investigation to show serum S100B levels after extracranial fracture in patients without current head injury and without prior neurological disease. METHODS: At the emergency department, we obtained the blood samples within 6 hours from trauma patients hospitalized with extracranial fractures. S100B levels were compared between one fracture and more than two fractures, and analyzed according to the presence of soft tissue damage. RESULTS: Patients with one fracture and those with more than two fractures did not differ by age (mean, 54.70 vs. 47.03, p=0.130), and there was no significant difference in the male-to-female ratio(33:32 vs. 21:12, p=0.226). In patients with one fracture, the mean value of S-100B was 0.56 microgram/L (95% CI: 0.35-0.77) whereas in those with more than two fractures, the corresponding value was 1.09 microgram/L (95% CI: 0.46-1.7, p=0.048). The S100B level of patients with soft tissue damage(1.32+/-0.38) was higher than that of patients without soft tissue damage(0.81+/-0.21), whether one fracture or more than two fractures(p=0.049). CONCLUSION: We present here that S100B levels were raised in 77% of patients with extracranial fractures without cerebral injury who were hospitalized from the emergency room and that the presence of soft tissue damage contributed to the increased S100B rather than the size of the fractured bone size or the number of fracturest. Thus, this study suggests that soft tissue injury may be considered as an important extracerebral source of S100B.

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