Association of Gluteus Medius and Minimus Muscle Atrophy and Fall-Related Hip Fracture in Older Individuals Using Computed Tomography.

Abstract

The aim of this study was to determine an association between fall-related hip and/or pelvic fractures and gluteus medius and minimus atrophy. Retrospective review of 64 patients with fall-related hip/pelvic fractures and 96 age- and sex-stratified controls was performed. Gluteus medius, gluteus minimus, tensor fascia lata, and iliopsoas atrophy was scored using a standard scale. Statistical analysis was performed. There is a significant difference (P < 0.0001) in gluteus medius and minimus atrophy in the fracture versus control groups. Presence of gluteus atrophy was predictive of fall-related fracture (odds ratio, 2.15; 95% confidence interval, 1.08-4.31). There is no significant difference in tensor fascia lata (P = 0.47) or iliopsoas (P = 0.15) atrophy between the 2 groups. Gluteus atrophy increased with age (r = 0.41, P < 0.0001). In unilateral fractures, there is a significant difference (P = 0.0002) in ipsilateral versus contralateral gluteus medius atrophy. Gluteus medius and minimus muscle atrophy is greater in fall-related hip/pelvic fractures, which may predispose the elderly to falls.