Os et nutrition : les aspects nutritionnels de la fracture de l'extrémité supérieure du fémur

Nearly 50% of elderly persons hospitalized for hip fracture are undernourished. This malnutrition is the result of insufficient energy intake and the catabolic stress response after surgery. Inadequate calcium intake and vitamin D insufficiency are common among people with hip fracture. Vitamin D in combination with calcium is nutritionally essential for the proper functioning of bone. Insufficient intake of calcium and its poor absorption, and associated vitamin D insufficiency, lead to a secondary parathyroid reaction and enhance bone loss. This malnutrition increases postsurgery morbidity and mortality. Malnutrition assessment must be performed in elderly patients with hip fracture, and vitamin D deficiency must be diagnosed by measurements of serum 25(OH)D levels. Early nutritional support after surgery could limit weight loss and improve the functional outcome.