Perioperative Nutritional Support and Management of Patients with Proximal Femur Fractures with Senile Asthenia

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Abstract
Introduction. Due to the development of medical technologies, improvement of the quality of medical care, progress in the field of disease prevention and lifestyle changes, the average life expectancy is constantly increasing. With age, bones become more fragile and prone to fractures; most often the proximal femur is damaged. Femoral fractures occur, as a rule, due to a fall on a flat surface, and mainly in people over the age of 60 years.It should be borne in mind that proper nutrition is one of the key components of treatment and recovery of the body. Patients in hospital may experience various digestive and appetite problems or have additional nutritional needs. Poor nutrition and insufficient protein intake can be a particularly important risk factor for hip fracture, and is often considered to be the cause of a high incidence of fracture complications in the elderly. Among various general geriatric pathologies, sarcopenia syndrome has attracted special attention in recent years, because its development leads to deterioration in the quality of life, and increases the risk of falls and complications after injury.Perioperative nutritional support plays an important role in the recovery of patients with senile asthenia and fractures of the proximal femur.A comprehensive multidisciplinary approach to the treatment of patients with senile asthenia and fractures of the proximal femur restores ability of self-care and limb support, raises the vitality and improves psychological state of the patient.The Aim of the review is to determine the role of perioperative nutritional support in the management of patients with fractures of the proximal femur and concomitant sarcopenia.Material and Methods. To write this review, we used the following electronic databases of scientific literature: PubMed, Cochrane Library, eLibrary, and Cyberleninka. The papers published in the period from January 1995 to May 2024 on the influence of sarcopenia on the incidence of postoperative complications, mortality rate and overall survival in elderly patients with fractures of the proximal femur were considered.Thanks to the review, it was indicated that so far there is no single view on a comprehensive multidisciplinary approach to the treatment of those patients, who should be carefully examined in order to identify nutritional deficiencies.There is also no complete perioperative algorithm in the available literature; and the issue of medical and social rehabilitation of this complex category of patients has not been resolved.Conclusion. There is a need to create such an algorithm that includes methods for screening and diagnosing nutritional insufficiency in elderly patients with fractures of the proximal femur.

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