Neutrophil functions in patients with fractures of the upper end of the femur.

In the present study, neutrophil functions were examined in vitro in 40 patients suffering from fractures of the upper end of the femur (trochanteric and subcapital). Adherence to nylon, serum chemotaxis, and phagocytosis-bactericidal function were assayed. Three microbial strains, namely, Staphylococcus aureus, S. epidermidis, and Pseudomonas aeruginosa, were used for the experiments. Adherence of the patients' neutrophils was found normal. On the contrary, the chemotactic ability of the patients' sera was inferior to that of healthy controls; phagocytosis and bactericidal function were also significantly impaired for all three bacterial strains. The results were independent of fracture site (intracapsular or extracapsular), sex, and age. The observed host defense disorders provide additional information that helps to explain the increased susceptibility of these patients to bacterial infections.