Pre-operative nutritional serum parameters as predictors of failure after internal fixation in undisplaced intracapsular proximal femur fractures
| Autor: | Adam Smith, Stefan Bajada, David Morgan |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
Reoperation medicine.medical_specialty medicine.medical_treatment Nutritional Status Fracture Fixation Internal Predictive Value of Tests Preoperative Care medicine Internal fixation Humans Binary logistic regression analysis Treatment Failure General Environmental Science Aged Retrospective Studies Aged 80 and over Hip fracture Proximal femur business.industry Malnutrition Nutritional status Middle Aged medicine.disease Pre operative United Kingdom Surgery Femoral Neck Fractures Socioeconomic Factors Radiological weapon General Earth and Planetary Sciences Cannulated screw Female business Biomarkers |
| Zdroj: | Injury. 46(8) |
| ISSN: | 1879-0267 |
| Popis: | Introduction Current management of undisplaced hip fractures is based on internal fixation. Reported revision rates of 12–17% for this procedure negatively impact on patient morbidity and mortality. The aim of this novel study is to examine if the nutritional status of these patients is associated with failure of internal fixation. Patients and methods A consecutive series of 111 undisplaced intracapsular hip fractures treated with cannulated screw was identified. These were retrospectively reviewed including routine admission serum investigations (lymphocyte count and albumin levels). Radiological investigations were used to assess fracture classification, posterior-tilt angle, fixation adequacy, screw configuration and failure (avascular-necrosis, non-union and screw cut-out). Results 16% of fixations failed (18 patients). Patients with fixation-failure had a significantly lower albumin (35 g/l vs. 40 g/l, p = 0.02) and lymphocyte count (0.7 × 109 l vs. 1.4 × 109 l, p ≤ 0.001) than non-failure patients. Lymphocyte count, albumin level and posterior-tilt angle were independent predicators of failure on binary logistic regression analysis. We suggest that routine laboratory tests can be used to identify patients at greatest risk of failure of internal fixation. |
| Databáze: | OpenAIRE |
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