Correlation of nutritional parameters in long bone diaphyseal fracture healing

Abstract

Purpose: To study whether the nutritional status of the patient has any effect on the outcome of fracture healing. To correlate various clinical and biochemical parameters for assessment of nutritional status with union of fracture.Material and Methods: One hundred and two patients having diaphyseal fractures of various long bones were followed prospectively for two years. The patients were categorized into ‘malnourished/ undernourished’ and ‘nourished’ status according to the anthropometric markers like body mass index, triceps skin fold thickness and mid arm muscle circumference; and biochemical markers like Hemoglobin, serum albumin, serum transferrin, serum ferritin and creatinine-height index. These fracture was evaluated clinically and radiologically for healing.This union time or quality of union was correlated with the anthropometric and biochemical parameters.Results: Femoral diaphyseal fractures were the commonest fracture identified (n=35, 34. 31%) followed by radius and ulna (28%), tibia and fibula (25%) and humanus (12%). High velocity road traffic accident was the most common mechanism of injury seen in 49 fractures (48.04%) followed by fall from height (40%) and Domestic trauma (12%). None of the biochemical parameters showed any correlation for fracture healing. Only Serum Albumin, Creatinine-Height index, Serum transferrin could show significant correlation with malnutrition and poor fracture healing.Conclusion: Thus our study concluded that serum albumin, serum transferrin and creatinine-height index were good biochemical indicators to predict union time. Anthropometric markers, so commonly considered for assessing deficiency in nutrition, do not correlate with fracture healing significantly and are meant for screening only. Altering the nutritional status while fracture treatment can promote healing.