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Operative management of acetabulum fractures in the obese patient: challenges and solutions

Authors Sardesai NR, Miller MA, Jauregui JJ, Griffith CK, Henn RF 3rd, Nascone JW

Received 20 January 2017

Accepted for publication 3 July 2017

Published 7 August 2017 Volume 2017:9 Pages 75—81

DOI https://doi.org/10.2147/ORR.S113424

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Professor Clark Hung


Neil R Sardesai, Michael A Miller, Julio J Jauregui, Cullen K Griffith, R Frank Henn 3rd, Jason W Nascone

Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD, USA

Abstract: In this review, we aim to increase our knowledge of the treatment of acetabular fractures in the obese patient population. The extremely high incidence of obesity in the USA is a looming health care concern that impacts aspects of health care in all medical specialties. There are specific concerns to the orthopedic surgeon when treating obese patients for acetabular fracture. Patients with body mass index ≥30 present particular challenges to the surgeon in terms of preexisting medical conditions, diagnostic imaging, and perioperative complications. Specifically, this patient population experiences worse functional outcomes and greater incidence of surgical site infection, intraoperative blood loss, deep venous thrombosis, post-traumatic osteoarthritis, heterotopic ossification, and increased hospital length of stay. These problems are further exacerbated in the morbidly obese, as a scaling effect exists between increasing body mass index and worsening complication profile. This is problematic given the current high incidence of morbid obesity in the USA and particularly worrisome in light of the projected increase in obesity rates for the future.

Keywords: hip fractures, obesity, BMI, morbidly obese, morbid obesity, diagnostic imaging, perioperative complications, functional outcomes, super-obesity, surgical comorbidities, cost, ORIF
 

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