Nutritional status and functional capacity after femoral neck fractures: Aprospective randomized one-year follow-up study

The primary aim of this study was to evaluate the effect of two different s urgical methods on nutritional status and functional capacity during the fi rst postoperative year in patients with displaced femoral neck fractures. A further aim was to evaluate the effect of nutritional support. One hundred patients were randomly assigned to treatment with either primary total hip arthroplasty (THA) or osteosynthesis. Half of the patients in each treatme nt group received protein- and energy-enriched food in the hospital in addi tion to individual nutritional advice in order to optimize their intake of protein- and energy-rich food. Nutritional state and functional capacity we re examined at baseline, one and three months, and one year after the opera tion. Pain was examined at three months and one year. The effect of nutriti onal intervention was equal within both surgical groups. Logistic regressio n showed that the dependent variable "living at one year" was significantly associated with serum albumin levels at one month. Advanced age, mental im pairment and deteriorated nutritional status were predominant in the non-su rvivors. Overall, the primary THA group performed better compared with the osteosynthesis group concerning weight change over time, locomotion and pai n. This study also showed that primary THA could safely be performed in the elderly without an increased postoperative mortality rare. (C)2000. Editri ce Kurtis.