Introduction:

Sarcopenia is defined as a progressive loss of muscle mass and function with increased age. The measurement of muscle mass and attenuation on the axial computed tomography (CT) scan has been reported to be a good indicator for sarcopenia in previous literature. This study aimed to compare muscle mass between the intertrochanteric fracture and femoral neck fracture groups by accurately measuring muscle mass around the hip joint using a CT scan.

Methods:

The cases were matched according to age and gender on a 1-to-1 basis. As a result, a total of 400 patients, 200 patients in each group with the same age and gender characteristics, were included in the study. At the disc of L4-L5 level, the cross-sectional area (CSA) of the psoas muscle was evaluated, and at the disc of L5-S1 level, the CSA of the psoas, iliacus and gluteus medius muscles were evaluated. In addition, attenuation was evaluated using the average Hounsfield Unit (HU) for the specific area.

Results:

The mean age of 400 patients (262 females, 138 male) included in the study was 78.49 ± 7.67 years. It was observed that the mean HU values of the patients in the femoral neck fracture group were significantly higher than the intertrochanteric fracture group (p < 0.001, p = 0.008; respectively). At the same time, the mean HU values of the gluteus medius muscle were higher in the femoral neck fracture group (p < 0.001), but in contrast with the psoas muscle, the CSA values of gluteus medius muscle were significantly higher in the intertrochanteric fracture group (p = 0.017).

Conclusions:

Fatty degeneration of the psoas muscle among the muscles around the hip may affect the type of hip fracture. Elderly patients with strong psoas muscles may experience femoral neck fracture due to contraction and torsion during falling.

中文翻译：

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腰大肌和臀中肌衰减对髋部骨折类型的影响

介绍：

肌肉减少症被定义为随着年龄的增长肌肉质量和功能的逐渐丧失。据报道，在以前的文献中，轴向计算机断层扫描 (CT) 扫描中肌肉质量和衰减的测量是肌肉减少症的良好指标。本研究旨在通过使用 CT 扫描准确测量髋关节周围的肌肉质量来比较转子间骨折组和股骨颈骨折组之间的肌肉质量。

方法：

这些病例根据年龄和性别进行一对一匹配。结果，共有400名患者，每组200名具有相同年龄和性别特征的患者被纳入研究。在L4-L5椎间盘，评估腰大肌的横截面积（CSA），在L5-S1椎间盘，评估腰大肌、髂肌和臀中肌的CSA。此外，使用特定区域的平均亨斯菲尔德单位 (HU) 评估衰减。

结果：

纳入研究的 400 名患者（262 名女性，138 名男性）的平均年龄为 78.49 ± 7.67 岁。观察到股骨颈骨折组患者的平均 HU 值显着高于粗隆间骨折组（分别为p  < 0.001，p  = 0.008）。同时，股骨颈骨折组臀中肌平均HU值较高（p  < 0.001），但与腰大肌相比，股骨粗隆间骨折臀中肌CSA值显着升高组（p  = 0.017）。

结论：

髋部周围肌肉中的腰大肌脂肪变性可能会影响髋部骨折的类型。腰大肌强壮的老年患者在跌倒时可能会因收缩和扭转而发生股骨颈骨折。