Comparison of fracture healing and complications after internal fixation in patients with intertrochanteric fracture with and without concomitant sarcopenia

doi:10.12307/2022.587

Abstract

Abstract: BACKGROUND: Sarcopenia is closely related to the occurrence of hip fractures. As sarcopenia is gradually recognized and studied, enough emphasis should be placed on patients with intertrochanteric fractures combined with sarcopenia, to further improve the curative effect on elderly femoral intertrochanteric fractures and reduce complications.
OBJECTIVE: To investigate fracture healing and complications after internal fixation in patients with intertrochanteric fracture concomitant with sarcopenia or not.
METHODS: A total of 128 patients with intertrochanteric fractures who underwent anti-rotation intramedullary fixation at the Department of Orthopedics in Chaohu Hospital of Anhui Medical University from January 2014 to December 2020 were selected, of which 61 patients were without sarcopenia, and 67 patients were with sarcopenia. The postoperative pain (visual analogue scale score), blood loss, fracture healing time, hospital stay, complications, and Harris hip score were statistically analyzed in the two groups.
RESULTS AND CONCLUSION: Of the 128 patients, 67 (52.3%) were diagnosed with sarcopenia. Compared with the non-sarcopenia group, patients in the sarcopenia group had longer hospital stays (P < 0.05), a higher incidence of complications (P < 0.05), and a lower Harris hip score (P < 0.05). The visual analogue scale scores of sarcopenia patients were higher than those of non-sarcopenia patients on the 1st and 3rd days after surgery (P < 0.05). To conclude, the incidence of sarcopenia is higher in patients with intertrochanteric fractures, and sarcopenia is a risk factor for poor prognosis in patients with intertrochanteric fractures, which should be spotlighted.

Key words: sarcopenia, intertrochanteric fracture, internal fixation, fracture healing, complication, enhanced recovery after surgery

CLC Number:

Xu Junjie, Li Yehai, Liu Qing, Wang Jian, Liang Junsheng, Liu Hefeng, Dai Ru. Comparison of fracture healing and complications after internal fixation in patients with intertrochanteric fracture with and without concomitant sarcopenia[J]. Chinese Journal of Tissue Engineering Research, 2022, 26(15): 2342-2346.

Figures/Tables 6

References

[1] WIEDMER P, JUNG T, CASTRO JP, et al. Sarcopenia - Molecular mechanisms and open questions. Ageing Res Rev. 2021;65:101200.
[2] WU X, LI X, XU M, et al. Sarcopenia prevalence and associated factors among older Chinese population: Findings from the China Health and Retirement Longitudinal Study. PLoS One. 2021;16(3):e0247617.
[3] LANDI F, CALVANI R, ORTOLANI E, et al. The association between sarcopenia and functional outcomes among older patients with hip fracture undergoing in-hospital rehabilitation. Osteoporos Int. 2017;28(5):1569-1576.
[4] BAYRAKTAR E, TASAR PT, BINICI DN, et al. Relationship between Sarcopenia and Mortality in Elderly Inpatients. Eurasian J Med. 2020;52(1):29-33.
[5] KIM YK, YI SR, LEE YH, et al. Effect of Sarcopenia on Postoperative Mortality in Osteoporotic Hip Fracture Patients. J Bone Metab. 2018;25(4):227-233.
[6] BACHETTINI NP, BIELEMANN RM, BARBOSA-SILVA TG, et al. Sarcopenia as a mortality predictor in community-dwelling older adults: a comparison of the diagnostic criteria of the European Working Group on Sarcopenia in Older People. Eur J Clin Nutr. 2020;74(4):573-580.
[7] HUANG P, LUO K, XU J, et al. Sarcopenia as a Risk Factor for Future Hip Fracture: A Meta-Analysis of Prospective Cohort Studies. J Nutr Health Aging. 2021;25(2):183-188.
[8] KIRK B, PHU S, BRENNAN-OLSEN SL, et al. Associations between osteoporosis, the severity of sarcopenia and fragility fractures in community-dwelling older adults. Eur Geriatr Med. 2020;11(3):443-450.
[9] MARZETTI E, CALVANI R, TOSATO M, et al. Sarcopenia: an overview. Aging Clin Exp Res. 2017;29(1):11-17.
[10] SI L, WINZENBERG TM, JIANG Q, et al. Projection of osteoporosis-related fractures and costs in China: 2010-2050. Osteoporos Int. 2015;26(7):1929-1937.
[11] NEMEC U, HEIDINGER B, SOKAS C, CHU L, et al. Diagnosing Sarcopenia on Thoracic Computed Tomography: Quantitative Assessment of Skeletal Muscle Mass in Patients Undergoing Transcatheter Aortic Valve Replacement. Acad Radiol. 2017;24(9):1154-1161.
[12] PÁR A, HEGYI JP, VÁNCSA S, et al. Sarcopenia - 2021: Pathophysiology, diagnosis, therapy. Orv Hetil. 2021;162(1):3-12.
[13] CHANG CD, WU JS, MHUIRCHEARTAIGH JN, et al. Effect of sarcopenia on clinical and surgical outcome in elderly patients with proximal femur fractures. Skeletal Radiol. 2018;47(6):771-777.
[14] CHEN LK, LIU LK, WOO J, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014;15(2):95-101.
[15] HIDA T, ISHIGURO N, SHIMOKATA H, et al. High prevalence of sarcopenia and reduced leg muscle mass in Japanese patients immediately after a hip fracture. Geriatr Gerontol Int. 2013;13(2):413-420.
[16] DI MONACO M, CASTIGLIONI C, BARDESONO F, et al. Sarcopenia, osteoporosis and the burden of prevalent vertebral fractures: a cross-sectional study of 350 women with hip fracture. Eur J Phys Rehabil Med. 2020;56(2):184-190.
[17] MALAFARINA V, MALAFARINA C, BIAIN UGARTE A, et al. Factors Associated with Sarcopenia and 7-Year Mortality in Very Old Patients with Hip Fracture Admitted to Rehabilitation Units: A Pragmatic Study. Nutrients. 2019;11(9): 2243.
[18] KIRK B, AL SAEDI A, DUQUE G. Osteosarcopenia: A case of geroscience. Aging Med (Milton). 2019;2(3):147-156.
[19] BINKLEY N, BUEHRING B. Beyond FRAX: it’s time to consider “sarco-osteopenia”. J Clin Densitom. 2009;12(4):413-416.
[20] CLYNES MA, GREGSON CL, BRUYÈRE O, et al. Osteosarcopenia: where osteoporosis and sarcopenia collide. Rheumatology (Oxford). 2021;60(2):529-537.
[21] CRUZ-JENTOFT AJ, BAHAT G, BAUER J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31.
[22] BYUN SE, KIM S, KIM KH, et al. Psoas cross-sectional area as a predictor of mortality and a diagnostic tool for sarcopenia in hip fracture patients. J Bone Miner Metab. 2019;37(5):871-879.
[23] SHAH AA, KUMAR S, SHAKOOR A, et al. Do delays in surgery affect outcomes in patients with inter-trochanteric fractures? J Pak Med Assoc. 2015;65(11 Suppl 3): S21-24.
[24] GOMEZ M, MARC C, TALHA A, et al. Fast track care for pertrochanteric hip fractures: How does it impact length of stay and complications? Orthop Traumatol Surg Res. 2019;105(5):979-984.
[25] JIANG M, LIU S, DENG H,et al. The efficacy and safety of fast track surgery (FTS) in patients after hip fracture surgery: a meta-analysis. J Orthop Surg Res. 2021;16(1):162.
[26] SHIN WC, JANG JH, SEO HE,et al. Prevalence and clinical impact of sarcopenia in osteoporotic hip fracture: Single center retrospective cohort study. Acta Orthop Traumatol Turc. 2020;54(1):27-33.
[27] KANG Y, LIU J, CHEN H, et al. Enhanced recovery after surgery (ERAS) in elective intertrochanteric fracture patients result in reduced length of hospital stay (LOS) without compromising functional outcome. J Orthop Surg Res. 2019;14(1):209.
[28] AKAN B. Influence of sarcopenia focused on critically ill patients. Acute Crit Care. 2021;36(1):15-21.
[29] Seo DY, Hwang BG. Effects of exercise training on the biochemical pathways associated with sarcopenia. Phys Act Nutr. 2020;24(3):32-38.
[30] GIELEN E, BECKWÉE D, DELAERE A, et al. Nutritional interventions to improve muscle mass, muscle strength, and physical performance in older people: an umbrella review of systematic reviews and meta-analyses. Nutr Rev. 2021;79(2): 121-147.
[31] BARAJAS-GALINDO DE, GONZÁLEZ ARNÁIZ E, Ferrero Vicente P, et al. Effects of physical exercise in sarcopenia. A systematic review. Endocrinol Diabetes Nutr (Engl Ed). 2021;68(3):159-169.
[32] 陈夏清,蒋波,田野.对老年肌少症患者使用运动指导的意义研究[J].中国现代药物应用,2020,14(19):237-238.