Study On The Relationship Between Fiber Atrophy And Inflammation In Lateral Femoral Muscle Of Elderly Hip Fracture Patients

ObjectiveTo explore the correlation between postoperative functional recovery and fiber atrophy of the vastus lateralis and local and systemic inflammation in elderly patients with hip fractures,and to provide new ideas for clinical treatment.MethodsA prospective study included 20 elderly patients with hip fractures treated with orthopedic surgery in the Department of Orthopaedics at the Army General Hospital of Southern Medical University between October 2017 and December 2017.Patients with older hip osteoarthritis who were eligible for the same period were included in the study.Six cases served as controls.The general clinical data of patients were collected after admission and grouped according to Harris Harris scores before and after surgery(functional recovery group and poor functional recovery group).Blood samples were taken from the patient's fracture/24 hours after admission for ELISA serum test.The content of IL-1?,IL-6,IL-8 and TNF-a.In the patient's surgery,the vastus lateralis muscle was taken for immunohistochemistry to analyze the cross-sectional area of type ? and type ? muscle fibers in the lateral femoral muscle of the patient,and the lateral femoral muscle was taken for Western blot analysis of local muscle IL-6/STAT3 and TWEAK./Fnl4 pathway inflammatory protein content.The patients were followed up regularly and Harris function scores were performed.The similarities and differences of muscle fiber atrophy and systemic and local inflammatory reactions in elderly patients with hip fracture group and elderly patients with hip osteoarthritis were statistically analyzed.The hip function was analyzed in patients with different postoperative functional recovery.The similarities and differences of muscle fiber atrophy and systemic and local inflammatory reactions in patients with fracture.Explore the relationship between muscle atrophy,local muscle inflammation and postoperative functional recovery.Results1.Severe release of inflammatory factors in post-traumatic circulation in elderly patients with hip fractures,plasma concentrations of IL-1?,IL-6,IL-8,TNF-?are greater than those in elderly patients with hip arthritis,and the difference is statistically significant.The plasma levels of IL-1?,IL-6,IL-8 and TNF-a in patients with poor postoperative functional recovery were significantly higher than those in patients with better functional recovery.2.Compared with hip arthritis patients of the same age,patients with hip fractures showed significant atrophy of both type I and type II muscle fibers.Patients with hip fractures with poor postoperative functional recovery had more significant I and II muscle fiber atrophy,with statistically significant differences.3.The expression of inflammation in the lateral femoral muscle of the elderly patients with hip fractures was up-regulated,and the expression of inflammatory factors such as p-STAT3,TWEAK-R,NF?B p-p65,NF?B p-p50,TRAF-6 was higher than that of elderly hip arthritis.Group,and the difference was statistically significant.The inflammatory signals of the vastus lateralis muscle in hip fracture patients with poor postoperative functional recovery were higher than those with better functional recovery.The difference was statistically significant.Conclusion1.Severe release of IL-1?,IL-6,IL-8,TNF-? and other inflammatory factors in the post-traumatic circulation of elderly patients with hip fractures,provoking systemic inflammatory response;Systemic inflammation is more common in patients with poor postoperative functional recovery strong.2.Compared with patients with hip arthritis in the same age group,patients with hip fracture in the elderly had more significant ? and ? type muscle fiber atrophy in the vastus lateralis muscle,and patients with poor postoperative functional recovery had more obvious atrophy.Type ? and type ? muscle fibers,especially type? muscle fiber atrophy,may be an important risk factor leading to decreased functional activity in the elderly and even hip fractures.3.Patients with hip fractures in the elderly showed increased levels of inflammation in the vastus lateralis muscle compared with patients with hip arthritis in the same age group.In patients with hip fractures with poor functional recovery,local inflammation of the vastus lateralis muscle was more pronounced.4.Muscle local inflammation may be an important cause of muscle fiber atrophy,affecting patients' postoperative functional recovery.