Trauma and fractures: Meeting your patient’s nutritional needs

Trauma, long bone fractures and sepsis all alter nutritional requirements related to hypermetabolism and endogenous protein catabolism. Failure to provide needed nutrients for these patients sets the stage for the development of protein calorie malnutrition and the associated complications of poor wound healing, delayed bony repair, infection, and increased risk of mortality. Use of nutritional screening will identify the high risk patient prone to protein calorie malnutrition at an early stage so that individualized nutritional support may be administered. This article presents a review of the metabolism of trauma and fracture healing, outlines nutritional screening parameters, and sets out guidelines for nutritional support selection.