Junsheng Leng1, Xiao Chang1, Qiushi Bai1, Yun Wang2, Xingyu Liu2, Jia Zhang1, Peng Gao1, Yu Fan1, Xiongfei Zou1, Hengyan Zhang1, Baozhong Zhang3. 1. Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China. 2. Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China. 3. Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China. zbz9639@sina.com.
Abstract
PURPOSE: Apart from bone conditions, muscle and soft tissue parameters might also influence hip fractures. We aimed to evaluate the association between hip muscle and trochanteric soft tissue parameters and hip fractures. METHODS: We retrospectively reviewed 60 patients with hip fractures and 114 controls without hip fractures. Cases and controls were matched for age, sex, and body mass index using propensity score matching. Muscle cross-sectional area (CSA), mean attenuation, and fatty infiltration rate (FIR) (proportion of intramuscular fat content) were measured on CT images for the gluteus maximus, the gluteus medius/minimus, and the anterior and medial compartments of the upper thigh. Trochanteric soft tissue thickness (TSTT) and femoral neck attenuation were also measured. Univariate and multivariate analyses were conducted to identify potential risk factors of hip fractures. RESULTS: Patients with hip fractures had significantly lower femoral neck attenuation, TSTT, and CSA of the gluteus maximus and anterior compartment than controls. FIR of all hip muscle groups were significantly higher in hip fracture patients than controls. Multivariate analysis revealed that every 1% increase in FIR of medial compartment independently increased the odds of hip fractures by 23.7% (OR = 1.237, 95% CI = 1.093-1.401) and every 1 cm longer TSTT independently decreased the odds by 32.8% (OR = 0.672, 95% CI = 0.477-0.946). CONCLUSION: Fatty infiltration of hip muscles can better discriminate hip fractures than muscle area. Increased TSTT is independently associated with low fracture risk.
PURPOSE: Apart from bone conditions, muscle and soft tissue parameters might also influence hip fractures. We aimed to evaluate the association between hip muscle and trochanteric soft tissue parameters and hip fractures. METHODS: We retrospectively reviewed 60 patients with hip fractures and 114 controls without hip fractures. Cases and controls were matched for age, sex, and body mass index using propensity score matching. Muscle cross-sectional area (CSA), mean attenuation, and fatty infiltration rate (FIR) (proportion of intramuscular fat content) were measured on CT images for the gluteus maximus, the gluteus medius/minimus, and the anterior and medial compartments of the upper thigh. Trochanteric soft tissue thickness (TSTT) and femoral neck attenuation were also measured. Univariate and multivariate analyses were conducted to identify potential risk factors of hip fractures. RESULTS: Patients with hip fractures had significantly lower femoral neck attenuation, TSTT, and CSA of the gluteus maximus and anterior compartment than controls. FIR of all hip muscle groups were significantly higher in hip fracture patients than controls. Multivariate analysis revealed that every 1% increase in FIR of medial compartment independently increased the odds of hip fractures by 23.7% (OR = 1.237, 95% CI = 1.093-1.401) and every 1 cm longer TSTT independently decreased the odds by 32.8% (OR = 0.672, 95% CI = 0.477-0.946). CONCLUSION: Fatty infiltration of hip muscles can better discriminate hip fractures than muscle area. Increased TSTT is independently associated with low fracture risk.
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