Skeletal Radiology

, Volume 47, Issue 11, pp 1541–1549 | Cite as

Effects of post-fracture non-weight-bearing immobilization on muscle atrophy, intramuscular and intermuscular adipose tissues in the thigh and calf

  • Akito YoshikoEmail author
  • Koun Yamauchi
  • Takayuki Kato
  • Koji Ishida
  • Teruhiko Koike
  • Yoshiharu Oshida
  • Hiroshi Akima
Scientific Article



Disuse and/or a non-weight-bearing condition changes muscle composition, with decreased skeletal muscle tissue and increased fat within (intramuscular adipose tissue, IntraMAT) and between (intermuscular adipose tissue, InterMAT) given muscles. Excessive adipose tissue contributes to dysfunctional and metabolically impaired muscle. How these adipose tissues change during orthopedic treatment (e.g., cast immobilization, daily use of crutches) is not well documented. This study aimed to quantify changes in IntraMAT, InterMAT, and thigh and calf muscle tissue during orthopedic treatment.

Materials and methods

We studied 8 patients with fifth metatarsal bone or fibular fractures. The ankle joint involved underwent plaster casting for approximately 4 weeks, with crutches used during that time. Axial T1-weighted MRI at the mid-thigh and a 30% proximal site at the calf were obtained to measure IntraMAT and InterMAT cross-sectional areas (CSAs) and skeletal muscle tissue CSA before treatment and 4 weeks afterward.


Thigh and calf muscle tissue CSAs were significantly decreased from before to after treatment: thigh, 85.8 ± 7.6 to 77.1 ± 7.3 cm2; calf, 53.3 ± 5.5 to 48.9 ± 5.0 cm2 (p < 0.05). None of the IntraMAT or InterMAT changes was statistically significant. There was a relation between the percentage change of thigh IntraMAT CSA and muscle tissue CSA (rs = −0.86, p < 0.01).


The 4 weeks of treatment primarily induced skeletal muscle atrophy with less of an effect on IntraMAT or InterMAT. There is a risk of increasing IntraMAT relatively by decreasing skeletal muscle tissue size during orthopedic treatment.


Cast immobilization Non-weight-bearing Muscle atrophy Intramuscular adipose tissue Intermuscular adipose tissue 



The authors gratefully thank the volunteers for their participation and the staff of the Department of Radiology in Akita Hospital.


This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.


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Copyright information

© ISS 2018

Authors and Affiliations

  • Akito Yoshiko
    • 1
    Email author
  • Koun Yamauchi
    • 1
    • 2
  • Takayuki Kato
    • 2
  • Koji Ishida
    • 1
    • 3
  • Teruhiko Koike
    • 1
    • 3
  • Yoshiharu Oshida
    • 1
    • 3
  • Hiroshi Akima
    • 3
    • 4
  1. 1.Graduate School of MedicineNagoya UniversityNagoyaJapan
  2. 2.Department of Orthopedic SurgeryAkita HospitalChiryuJapan
  3. 3.Research Center of Health, Physical Fitness & SportsNagoya UniversityNagoyaJapan
  4. 4.Graduate School of Education and Human DevelopmentNagoya UniversityNagoyaJapan

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