This study aims to evaluate the frailty status of elderly patients undergoing surgery for hip fractures (femur trochanteric fractures). Since frailty is a critical factor in surgical outcomes and recovery, researchers want to find simple, fast, and objective ways to measure it. This study will investigate muscle thickness measured by ultrasound, handgrip strength measured by a dynamometer, and routine blood test values can accurately predict a patient's frailty level. If these objective methods are proven effective, it will help anesthesia and surgical teams manage the perioperative process more safely for high-risk elderly patients

65 and over years old elderly patients admitted to the orthopedics department with a diagnosis of trochanteric femur fracture will be enrolled in this study.

Preoperative Assessment: A researcher anesthesiologist, who is not involved in the patient's perioperative clinical management, will conduct the assessments to ensure objectivity. One day prior to the scheduled surgery, the following procedures will be performed:

Frailty Evaluation: Clinical frailty status will be determined using the Clinical Frailty Scale. In conjunction with this, handgrip strength will be measured using a calibrated hand dynamometer.

Ultrasonographic Measurements: Ultrasound will be used to measure the thickness of the rectus femoris muscle and the distance from the femur to the skin. These measurements will serve as objective indicators of musculoskeletal status.

Data Collection: Demographic data (age, weight, height, comorbidities) and routine preoperative laboratory results will be recorded from the hospital's electronic medical records. Laboratory parameters to be analyzed include:

Hematological: Hemoglobin, MPV, MCV, Neutrophil, and Lymphocyte counts.

Biochemical: Albumin, Creatinine, CRP, and GFR.

The study focuses on evaluating the correlation between these objective measurements (ultrasound and dynamometry) and the established clinical frailty scores to determine their predictive value in the geriatric surgical population.

Inclusion Criteria:

• Patients aged 65 years and older.
• Confirmed diagnosis of trochanteric femur fracture.
• Planned for orthopedic surgery under general or regional anesthesia.
• Ability to provide written informed consent (either by the patient or a legal representative).

Exclusion Criteria:

• Patients with advanced dementia or severe cognitive impairment who cannot cooperate with the handgrip strength test or Fried criteria questionnaire.
• Patients with terminal-stage diseases or those under palliative care.
• History of neuromuscular diseases or severe muscle-wasting conditions that affect the lower limbs (e.g., advanced muscular dystrophy).
• Patients with active infections or skin lesions at the site of ultrasound measurement (rectus femoris area).
• Emergency cases requiring immediate surgery where preoperative assessment cannot be completed.

The study population consists of geriatric patients aged 65 years and older who have been hospitalized at the Orthopedics and Traumatology department of Mugla Sitki Kocman University Training and Research Hospital with a diagnosis of trochanteric femur fracture. This population includes patients scheduled for elective or semi-urgent orthopedic surgery who are capable of undergoing preoperative clinical and ultrasonographic assessments.

Individual participant data (IPD) will not be shared to protect the privacy of the participants and to maintain confidentiality in accordance with the institutional review board's (Mugla Sitki Kocman University Ethics Committee) regulations and local data protection laws.