Substantial Loss of Skeletal Muscle Mass Occurs After High Energy Trauma

John Davison; Aspen Miller; Steven Leary; Emiko Hasegawa; Steele McCulley; Natalie Glass; Ruth Grossman; J L Marsh; Michael Willey

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Substantial Loss of Skeletal Muscle Mass Occurs After High Energy Trauma

Journal article

Open access

Peer reviewed

Substantial Loss of Skeletal Muscle Mass Occurs After High Energy Trauma

John Davison, Aspen Miller, Steven Leary, Emiko Hasegawa, Steele McCulley, Natalie Glass, Ruth Grossman, J L Marsh and Michael Willey

The Iowa orthopaedic journal, Vol.45(1), pp.247-254

2025

PMCID: PMC12212343

PMID: 40606707

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https://pmc.ncbi.nlm.nih.gov/articles/PMC12212343/View

Published (Version of record) Open Access

Abstract

The aim of this study was too quantify loss of skeletal muscle mass that occurs early after high energy trauma and determine the association with poor nutrition intake. This prospective cohort study was completed at a midwest academic level 1 trauma center. Patients aged 18 - 55 years old with acute open fracture of the extremity/pelvis and/or two or more injured extremities treated with operative fixation were enrolled. Body composition was measured with bioelectrical impedance analysis at time of injury, 6 weeks, and 12 weeks after injury (Lean Body Mass (LBM), Skeletal Muscle Mass (SMM), Percent Body Fat (%BF)).Dietary intake was measured with the Vioscreen® survey at time of injury and at 3 months. Baseline to post-operative changes in body composition were evaluated using repeated measures generalized linear models (GLM). To determine whether body composition changes differed according to baseline protein insufficiency, subjects were grouped according to baseline protein insufficiency status (<0.8 g protein/Kg Bodyweight, y/n) and analyses were repeated with addition of a group*time interaction term to GLM models. Twenty patients (male, n=16 (80%)), mean age 37.7 SD 12.4 years) from June 2021 - June 2022 were enrolled. Subjects lost significant LBM at 6 weeks (mean = -5.2kg SD5.6kg, p=0.0007), 12 weeks (mean = -5.3kg SD5.5 kg, p=0.0017), and 24 weeks (mean = -8.3kg SD 7.3kg, p=0.0037). and significant SMM at 6 weeks (mean= -3.0kg SD 3.3kg, p=0.0009), 12 weeks (mean = -3.1 kg SD 3.2 kg, p=0.0013) and 24 weeks (mean = -4.8kg SD 4.4kg, p= 0.0049). There was also a significant increase in %BF seen at follow-up (0.45% SD 0.16%, p<0.05). Five out of 20 subjects were protein deficient at the time of injury. Protein deficiency was not associated with loss of LBM or SMM. This study documented significant loss of LBM and SMM and increases in %BF after high energy musculoskeletal trauma. Insufficient protein intake was not associated with greater loss of muscle mass in this small series. .

Adolescent

Adult

Body Composition - physiology

Female

Fractures, Bone - complications

Fractures, Bone - surgery

Humans

Male

Middle Aged

Muscle, Skeletal - injuries

Muscle, Skeletal - pathology

Muscle, Skeletal - physiopathology

Prospective Studies

Young Adult

Details

Title: Subtitle: Substantial Loss of Skeletal Muscle Mass Occurs After High Energy Trauma
Creators: John Davison - University of Iowa
Aspen Miller - University of Iowa
Steven Leary - University of Iowa
Emiko Hasegawa - Des Moines University
Steele McCulley - University of Iowa
Natalie Glass - University of Iowa
Ruth Grossman - University of Iowa
J L Marsh - University of Iowa
Michael Willey - University of Iowa
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.45(1), pp.247-254
PMID: 40606707
PMCID: PMC12212343
NLM abbreviation: Iowa Orthop J
ISSN: 1555-1377
eISSN: 1555-1377
Publisher: University of Iowa
Language: English
Date published: 2025
Academic Unit: Orthopedics and Rehabilitation; Injury Prevention Research Center
Record Identifier: 9984843245702771

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