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

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Abstract

Objective

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.

Results

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).

Conclusions

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.

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Acknowledgements

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

Funding

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

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Authors and Affiliations

  1. Graduate School of Medicine, Nagoya University, Nagoya, Japan

    Akito Yoshiko, Koun Yamauchi, Koji Ishida, Teruhiko Koike & Yoshiharu Oshida

  2. Department of Orthopedic Surgery, Akita Hospital, Chiryu, Japan

    Koun Yamauchi & Takayuki Kato

  3. Research Center of Health, Physical Fitness & Sports, Nagoya University, Nagoya, Japan

    Koji Ishida, Teruhiko Koike, Yoshiharu Oshida & Hiroshi Akima

  4. Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan

    Hiroshi Akima

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  1. Akito Yoshiko
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Correspondence to Akito Yoshiko.

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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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Yoshiko, A., Yamauchi, K., Kato, T. et al. Effects of post-fracture non-weight-bearing immobilization on muscle atrophy, intramuscular and intermuscular adipose tissues in the thigh and calf. Skeletal Radiol 47, 1541–1549 (2018). https://doi.org/10.1007/s00256-018-2985-6

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  • DOI: https://doi.org/10.1007/s00256-018-2985-6

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