Low handgrip strength is associated with a higher incidence of pressure ulcers in hip fractured patients


orthopaedic surgery ; complications ; pressure ulcers ; hip fracture

Published online: Sep 30 2018

Enrique Diaz De Leon Gonzalez , Luis Leonardo Leyva Mendivil , Deborah Patricia Salinas Garza , Hugo Gutierrez Hermosillo , Juan Humberto Medina Chavez , Rebeca Palacios Corona

From the Internal Medicine Department, Unidad Médica de Alta Especialidad Hospital de Traumatología y Ortopedia No. 21, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México


Pressure ulcers (PUs) are highly frequent in hip fractured elderly patients. This issue has a direct impact in quality of life, mortality as well as healthcare costs. Handgrip strength (HGS) is an efficient, low-cost and straightfoward method to measure functional capacity, as well as the global muscle strength of elderly patients. In this research we are aiming to analyze if low HGS is associated with higher incidence of pressure ulcers within a population of elderly patients with hip fracture from a tertiary hospital from Monterrey, Mexico.

This research, designed as an observational-longi- tudinal cohort, included 462 patients admitted at the Hip and Pelvic Surgery Department of the Hospital of Traumatology and Orthopedics No. 21, of the Mexican Institute of the Social Security (IMSS), in Monterrey, Mexico. HGS measurement was performed by a trained physician, using a Jamar® Hydraulic Hand DynamometerPatients were grouped into tertiles according to their grip strength measurement and sex. Every patient was evaluated for presence or absence of PUs during hospital admission and followed until discharge.

The general incidence of PUs was 25.7%. The incidence was higher in the weaker subjects (Tertile one 33%, Tertile two 30%, and Tertile three 15%, P=0.001). Pre-fracture Barthel’s index, and Mini Nutritional Assessment Scores were lower among participants with PUs. After multivariate analysis, only HGS remained associated with PUs incidence. Low handgrip strength is associated with a higher incidence of pressure ulcers.