The Influence of an Anabolic Agent on the Nitrogen Balance of Patients with Major Extremity Fractures

Negative nitrogen balance has been repeatedly demonstrated following major operations and trauma. A prolonged catabolic period (negative nitrogen balance) subsequent to major fractures of the extremities has been described by Cuthbertson and Howard.^1,6 This response has been characterized by a large negative nitrogen balance maximal from the fourth to the eighth day after the fracture, lasting for as long as two months, and essentially unaffected by a high-protein, high-caloric diet. This investigation is concerned with the repetition of Cuthbertson's and Howard's studies and the testing of the influence of 17α-ethyl-17-hydroxynorandrostenone, or norethandrolone (Nilevar),* on nitrogen balance after fractures.

Methods  Eight patients with major fractures of the femur have been studied on the Metabolic Division at the Homer G. Phillips Hospital. Nitrogen balance studies were begun as soon as possible after injury and fixation of the fractures. The diet consisted of a powdered food† which permitted the giving of a