Introduction: Sarcopenia is defined as a progressive loss of muscle mass and function with increased age. The measurement of muscle mass and attenuation on the axial computed tomography (CT) scan has been reported to be a good indicator for sarcopenia in previous literature. This study aimed to compare muscle mass between the intertrochanteric fracture and femoral neck fracture groups by accurately measuring muscle mass around the hip joint using a CT scan. Methods: The cases were matched according to age and gender on a 1-to-1 basis. As a result, a total of 400 patients, 200 patients in each group with the same age and gender characteristics, were included in the study. At the disc of L4-L5 level, the cross-sectional area (CSA) of the psoas muscle was evaluated, and at the disc of L5-S1 level, the CSA of the psoas, iliacus and gluteus medius muscles were evaluated. In addition, attenuation was evaluated using the average Hounsfield Unit (HU) for the specific area. Results: The mean age of 400 patients (262 females, 138 male) included in the study was 78.49 ± 7.67 years. It was observed that the mean HU values of the patients in the femoral neck fracture group were significantly higher than the intertrochanteric fracture group ( p < 0.001, p = 0.008; respectively). At the same time, the mean HU values of the gluteus medius muscle were higher in the femoral neck fracture group ( p < 0.001), but in contrast with the psoas muscle, the CSA values of gluteus medius muscle were significantly higher in the intertrochanteric fracture group ( p = 0.017). Conclusions: Fatty degeneration of the psoas muscle among the muscles around the hip may affect the type of hip fracture. Elderly patients with strong psoas muscles may experience femoral neck fracture due to contraction and torsion during falling.

Objectives: This study aimed to define the optimal efficacy route of tranexamic acid treatment given during hemiarthroplasty after femoral neck fracture. Methods: This study examined the files of patients with hip fractures over 65 years of age and treated surgically in our clinic between 2017 and 2019. Patients included in these files were grouped as non-tranexamic acid and topical and systemic tranexamic acid. Then, the demographic information, height and weight of the patient files, haemoglobin and hematocrit levels before and after the surgery, bleeding profiles, tranexamic acid dose and the route of administration, complications in postoperative follow-up, the amount of fluid coming from the drain and duration of drainage, postoperative intensive care follow-up duration of hospitalisation was investigated. Results: A total of 100 patients, 50 of whom were in the control group, 25 of whom were treated with topical tranexamic acid, and 25 of whom were treated with intravenous tranexamic acid, were included in this study. Postoperative blood transfusion was applied to 60% (n = 30) of the control group, 20% (n = 5) of the topical group, and 24% (n = 6) of the intravenous group. When compared statistically, it was found that topical and intravenous groups were lower than the control group (p = 0.001 and p = 0.002, respectively), but there was no significant difference between them (p = 0.759). When the blood loss calculations made by the Gross method were examined, the average of the control group was 1011.5 ml (179-1837 ml), the topical group was 695.7 ml (11-2503 ml), and the intravenous group was 710.9 ml (173-11315 ml) calculated as. When analysed statistically in terms of blood loss, it was found that the control group was significantly higher than the topical and intravenous groups, but there was no significant difference between the topical and intravenous groups (p = 0.002). Conclusions: Tranexamic acid applied to reduce blood loss during arthroplasty surgery can be used effectively either by topical or systemic methods.