Regional Muscle Balance and Hip Fracture Patterns

NCT07443046 | Completed

• 1 other identifier: TABED 2-24-273
• Study Type: observational
• Target: 79
• Locations: 1 country
• Sites: 1

Brief Summary

Hip fractures are common in older adults and are often associated with muscle loss and frailty. While many studies focus on overall muscle reduction (sarcopenia), the role of regional muscle balance around the hip remains unclear. This prospective observational study aims to evaluate whether differences in muscle distribution, particularly between the gluteus medius and psoas muscles measured using computed tomography (CT), are associated with different hip fracture patterns. The study also investigates the potential effects of socioeconomic status, nutritional risk, and comorbidity burden on fracture configuration. Understanding how regional muscle characteristics relate to hip fracture types may provide new insight into biomechanical mechanisms and support future prevention and rehabilitation strategies for older adults.

Conditions

Hip Fracture; Sarcopenia; Muscle; Frailty

Keywords

Regional Muscle Balance; Gluteus Medius; Psoas Muscle; CT-Based Muscle Measurement; Hip Fracture Pattern; Geriatric Fracture; Musculoskeletal Biomechanics

Outcome Measures

Primary Outcomes (1)

• Hip Fracture Pattern

  Fracture configuration classified based on radiographic evaluation at hospital admission.

  Baseline (at admission)

Secondary Outcomes (8)

• Gluteus-to-Psoas Ratio

  Baseline

• Total Psoas Muscle Area

  Baseline

• Gluteus Medius Muscle Area

  Baseline

• Appendicular Skeletal Muscle Mass Index (ASMI)

  Baseline

• Psoas Muscle Index (PMI)

  Baseline

Study Arms (2)

Femoral Neck Fracture (FNF)

Older adults (≥60 years) with hip fracture classified as femoral neck fracture after low-energy fall; CT-based muscle measurements and clinical variables were assessed.

Intertrochanteric Femur Fracture (ITFF)

Older adults (≥60 years) with hip fracture classified as intertrochanteric femur fracture after low-energy fall; CT-based muscle measurements and clinical variables were assessed.

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Older adults aged 60 years and older presenting with hip fractures after low-energy falls were prospectively enrolled. Participants were evaluated in a tertiary care orthopedic trauma center, and fracture types were classified as femoral neck fracture or intertrochanteric femur fracture. All participants underwent standardized clinical assessment and CT-based muscle measurements at admission.

You may qualify if:

• Age ≥60 years
• Presentation with hip fracture following a low-energy fall
• Availability of pelvic computed tomography (CT) imaging at admission
• Ability to provide written informed consen

You may not qualify if:

• Pathological fractures
• Active malignancy
• Subtrochanteric fractures (≥5 cm distal to the lesser trochanter)
• High-energy trauma
• Neuromuscular disorders affecting muscle morphology
• Inflammatory systemic diseases
• Hemiparesis secondary to cerebrovascular events
• Refusal to participate in the study

Sponsors & Collaborators

• Ankara City Hospital Bilkent: lead

Study Sites (1)

Ankara Bilkent City Hospital

Ankara, Çankaya, 06800, Turkey (Türkiye)

Location

Related Publications (5)

• Wang L, Yang M, Ge Y, Liu Y, Su Y, Guo Z, Huang P, Geng J, Wang G, Blake GM, He B, Yin L, Cheng X, Wu X, Engelke K, Vlug AG. Muscle size and density are independently associated with death after hip fracture: A prospective cohort study. J Cachexia Sarcopenia Muscle. 2023 Aug;14(4):1824-1835. doi: 10.1002/jcsm.13261. Epub 2023 May 19.

  PMID: 37208980 RESULT

• Guven S, Naldoven OF, Alkan H, Erdogan Y, Cepni S, Veizi E. Laterally Protruded Cephalomedullary Nail Lag Screws are a Source of Consistent Thigh Pain After Pertrochanteric Fracture. J Orthop Trauma. 2024 Jun 1;38(6):320-326. doi: 10.1097/BOT.0000000000002803.

  PMID: 38470134 RESULT

• Kim KH, Lee JH, Lim EJ. Weak psoas and spine extensors potentially predispose to hip fracture. Hip Int. 2021 May;31(3):430-434. doi: 10.1177/1120700020904337. Epub 2020 Jan 30.

  PMID: 31997667 RESULT

• Veizi BGY, Imeri V, Naldoven OF, Guven S. Sarcopenia and sarcopenic obesity: Their association with postoperative outcomes in patients with hip fractures. J Hosp Med. 2025 Aug;20(8):816-823. doi: 10.1002/jhm.70007. Epub 2025 Feb 16.

  PMID: 39956950 RESULT

• Yerli M, Yuce A, Ayaz MB, Bayraktar TO, Erkurt N, Dedeoglu SS, Imren Y, Gurbuz H. Effect of psoas and gluteus medius muscles attenuation on hip fracture type. Hip Int. 2023 Sep;33(5):952-957. doi: 10.1177/11207000221101169. Epub 2022 Jun 5.

  PMID: 35658691 RESULT

MeSH Terms

Conditions

Hip Fractures; Sarcopenia; Frailty

Condition Hierarchy (Ancestors)

Femoral Fractures; Fractures, Bone; Wounds and Injuries; Hip Injuries; Leg Injuries; Muscular Atrophy; Neuromuscular Manifestations; Neurologic Manifestations; Nervous System Diseases; Atrophy; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pathologic Processes

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Orthopedic Surgeon

Study Record Dates

• First Submitted: February 25, 2026
• First Posted: March 2, 2026
• Study Start: July 1, 2024
• Primary Completion: July 1, 2025
• Study Completion: July 1, 2025
• Last Updated: March 3, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)