Nutritional differences in patients with proximal femoral fractures.
BACKGROUND
The reason why elderly human hips tend to break in one of two anatomical regions is uncertain. Nutritional factors may affect the site of fracture.


OBJECTIVE
To assess possible nutritional differences in patients with proximal femoral fractures.


METHODS
Prospective observational cohort study.


METHODS
University teaching hospital.


METHODS
119 consecutive patients over the age of 65 with a hip fracture admitted to the trauma wards in a single centre.


METHODS
One researcher measured triceps, biceps and supra-iliac skinfold thickness, and mid upper arm circumference on admission and on the fifth post-operative day. Body mass index was calculated for each patient, and used to classify patients as severely, moderately or mildly malnourished, normal, overweight or obese. Logistic regression was used to determine the influence of various factors on fracture site.


RESULTS
According to their body mass index, 31% of patients were classified as malnourished and 11% as severely malnourished. Patients with intracapsular fractures were significantly more malnourished than patients with trochanteric fractures (P < 0.008). Nutritional status was not related to post-operative complications. Ability to weigh a patient on the fifth post-operative day was the single most important prognostic indicator for complications.


CONCLUSIONS
Patients with intracapsular fractures are more malnourished. Those with trochanteric fractures tend to be overweight.
Maffulli
N
N
Department of Orthopaedic Surgery, University of Aberdeen Medical School, Scotland, UK. n.maffulli@abdn.ac.uk
Dougall
T W
TW
Brown
M T
MT
Golden
M H
MH
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006620:Hip Fractures / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009748:Nutrition Disorders; D009752:Nutritional Status / Q000502:physiology*; D011446:Prospective Studies