Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
BMC Geriatr. 2023 Feb 2;23(1):65. doi: 10.1186/s12877-023-03782-9.
Handgrip strength (HGS) has been adopted as one of the diagnostic tools for sarcopenia and is gaining attention because of its association with osteoporotic hip fractures. Longitudinal data of HGS at multiple follow-up intervals in older hip fractures are lacking. We aimed to investigate and compare the HGS changes in patients with hip fracture within 1-year with those in patients with hip diseases.
This prospective study was conducted between June 2018 and July 2020. The HGS was measured preoperatively, at predischarge, and at 3, 6, and 12 months postoperatively. We prospectively compared the number of patients with low muscle strength (LMS) as well as the HGS changes over time between the two groups.
A total of 115 consecutive patients with hip fracture (n = 58) and hip disease (57) were enrolled. The rate of preoperative LMS was higher in the hip fracture group than control (P = 0.005), but there was no significant difference in the postoperative period (P = 0.343). The mean HGS was lower in the hip fracture group at all measured time periods. The preoperative HGS increased right before discharge (15.2 kg to 17.0 kg), and plateaued thereafter 1-year in the fracture group, whereas there were no statistically significant changes in serial follow-up trends in the control group.
The preoperative HGS in fracture patients may have been underestimated, due to different position of the arm, insufficient practice, or pain. Subsequently, HGS was rather constant during 1-year indicating no development of general sarcopenia after treatment for hip fracture. Therefore, in hip fracture patients, the predischarge HGS might be more reliable than preoperative HGS.
握力（HGS）已被用作肌少症的诊断工具之一，由于其与骨质疏松性髋部骨折相关而受到关注。老年人髋部骨折后多次随访间隔的 HGS 纵向数据尚缺乏。我们旨在研究和比较髋部骨折患者与髋部疾病患者在 1 年内的 HGS 变化。
这是一项前瞻性研究，于 2018 年 6 月至 2020 年 7 月进行。术前、出院前以及术后 3、6 和 12 个月测量 HGS。我们前瞻性地比较了两组患者中肌肉力量较弱（LMS）的患者数量以及随时间的 HGS 变化。
共纳入 115 例连续髋部骨折（n=58）和髋部疾病患者（n=57）。髋部骨折组术前 LMS 发生率高于对照组（P=0.005），但术后无显著差异（P=0.343）。所有测量时间点，髋部骨折组的平均 HGS 均较低。骨折组的术前 HGS 在出院前增加（15.2kg 增加至 17.0kg），此后在 1 年内趋于稳定，而对照组的随访趋势没有统计学意义上的变化。
由于手臂位置、练习不足或疼痛等原因，骨折患者的术前 HGS 可能被低估。随后，HGS 在 1 年内相当稳定，表明髋部骨折治疗后不会发展为一般的肌少症。因此，在髋部骨折患者中，出院前的 HGS 可能比术前 HGS 更可靠。
