Operative treatment of acute hip fractures: its effect on serum creatine kinase, lactate dehydrogenase and their isoenzymes.

Serum creatine kinase, lactate dehydrogenase, and their isoenzymes were prospectively studied in 16 patients who underwent operative treatment of acute hip fractures. No perioperative myocardial infarctions occurred; however, two patients died of noncardiac causes. We found that skeletal muscle injury associated with operative treatment of acute hip fractures did not result in significant elevations of serum CK-MB or the LD-1/LD-2 ratio. CK-MB activity exceeding 5% of total CK activity was observed in five patients who did not experience acute perioperative myocardial infarction; however, no patient had an absolute CK-MB value exceeding 50 IU/L. Elevations of serum CK-MB exceeding 50 IU/L and a LD-1/LD-2 ratio exceeding 1.0, therefore, should not be attributed to skeletal muscle injury alone following the operative treatment of acute hip fractures.