Obesity is associated with increased postoperative complications after operative management of distal humerus fractures

Werner, Brian C.; Rawles, Robert B.; Jobe, J. Taylor; Chhabra, Arvind; Freilich, Aaron M.

doi:10.1016/j.jse.2015.04.019

Cited by 32 publications

(14 citation statements)

References 37 publications

(48 reference statements)

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“…The main goal of the treatment of intra-articular DHF is anatomical reduction of the joint surface and a stable fixation that allows early rehabilitation without failure of fixation. Although good functional results have been reported in the literature for the treatment of DHF with anatomical plates, many complications can be seen in the treatment of these fractures [19][20][21][22][23][24]. The most important finding of this present study was that 79% patients with a type C distal humerus fracture who were treated with double plating were able to return to pre-injury work in a mean 6.5 ± 2.4 months (range [3][4][5][6][7][8][9][10][11][12].…”

Section: Discussionmentioning

confidence: 53%

Analysis of Factors Affecting Return to Work After Surgical Treatment in Patients with AO Type C Distal Humerus Fractures

Kumbaracı¹,

Basa²,

Turgut³

2020

IJOO

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Background The purpose of this study is to evaluate the functional results of distal humerus fractures which were treated by open reduction and fixation with pre-contoured angular stable plates in young patients, and investigate whether the patients could return to their pre-injury work and patients' financial conditions while they were not working. Materials and MethodsThe data of 48 patients, ages between 18 and 55 years, working in a job and having AO/OTA type C distal humerus fracture were retrospectively evaluated. Mayo Elbow Performance Score (MEPS) was used to determine functional results. Postoperative radiographs were evaluated to determine the rate of union, degenerative changes, malunion and heterotopic ossification. Financial outcome form was constituted by the authors and the patients asked whether she/he could return to their pre-injury works after treatment finished and the financial status of the patients during the treatment and after the treatment. ResultsThe mean flexion-extension arc was 114° ± 12°(range 85°-135°) and the mean MEPS score was 85 ± 11(range 65-100). The average time to return to work was 6.5 ± 2.4 months (3-12 months). AO type C2 and C3 fractures and heterotopic ossification negatively affected the functional results and also adversely affected the patients' return to their pre-injury works. 38 (79%) patients returned to pre-injury work and 29 (76%) of them started to work at the same position before the fracture occured. Nine of 38 patients (24%) had to change their positions. Among the 48 patients, 10 patients (21%) could not return to the same work, 7 of them found light duty and 3 of them had not been to work. Conclusion Although the functional results of surgical treatment of intra-articular distal humerus fractures are good, at the end of the treatment, especially heavy workers may have difficulties in returning to their former works.

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Section: Discussionmentioning

confidence: 53%

Analysis of Factors Affecting Return to Work After Surgical Treatment in Patients with AO Type C Distal Humerus Fractures

Kumbaracı¹,

Basa²,

Turgut³

2020

IJOO

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“…Obesity has been identified as a vital risk factor for cardiovascular diseases [1] and various diseases involving an acute or a long-term chronic inflammatory response, such as asthma [2], Alzheimer's disease [3], as well as in trauma [4,5] and postoperative patients [6]. Despite an increasing number of studies reporting the positive relationship between obesity and multiple diseases, the link remains controversial.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Fat Distribution on the Inflammatory Response of Multiple Trauma Patients—A Retrospective Study

Chen

Wittenberg

Auer

et al. 2021

Life

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Objectives In recent years; increasing evidence pointed out the clinical importance of adipose tissue (AT) distribution in various patient populations. In particular, visceral adipose tissue (VAT), when compared to subcutaneous adipose tissue (SAT), was found to play a pivotal role in the development of inflammatory reaction. The aim of the present study was to examine whether body fat distribution has an impact on the development of systemic inflammatory response syndrome (SIRS) in patients with polytrauma. Methods In our retrospective study; we filtered our institution records of the German Trauma Registry (Trauma Register DGU) from November 2018 to April 2021 and included 132 adult polytrauma patients with injury severity score (ISS) >16. Subsequently; we measured the visceral and subcutaneous adipose tissue area based on whole-body CT scan and calculated the ratio of VAT to SAT (VSr). Thereafter, the patient population was evenly divided into three groups; respectively VSr value less than 0.4 for the first group (low ratio), 0.4–0.84 for the second group (intermediate ratio), and greater than 0.84 for the third group (high ratio). Considering the other influencing factors; the groups were further divided into subgroups in the respective analysis according to gender (male/female), BMI (<25 or ≥25), and ISS (<26 or ≥26). Result VSr was an independent factor from body mass index (BMI) (r2 = 0.003; p = 0.553). VSr in male patients was significantly higher (p < 0.001). Patients with low VSr had higher ISS scores (p = 0.028). Polytrauma patients with higher VSr tended to have lower SIRS scores and significant differences of SIRS score were found on multiple days during the whole hospitalization period. In the low VAT/SAT group, male patients, and patients with BMI greater than 25, both exhibited higher SIRS scores during hospital stay (day 16: p = 0.01; day 22: p = 0.048 and p = 0.011; respectively). During hospitalization, patients with higher ISS score (≥26) in the low VSr group was found to have higher SIRS score (day 16; p = 0.007). Over the hospital stay; serum markers of CRP; CK; and leukocyte in patients with low VSr were higher than those in patients in the intermediate and high VSr groups; with significant difference discovered on multiple days (day 16: 0.014; day 22: p = 0.048). Conclusion Lower VSr is associated with increased inflammatory response and worse clinical outcome in patients with polytrauma. Furthermore; VSr is an independent factor providing additional information to BMI.

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“…There is a well-established association between increasing BMI and the probability of sustaining a musculoskeletal injury, including certain types of fractures [8]. Furthermore, several retrospective studies have identifi ed an increased risk of postoperative complications for fractures involving the ankle, tibia, femur, humerus and pelvis [7,[9][10][11][12][13][14][15]. However, the literature regarding the clinical outcomes of hospitalized obese trauma patients who sustain fractures is limited despite the increasing prevalence of obesity among this population.…”

Section: Introductionmentioning

confidence: 99%

Obese trauma patients who sustain orthopaedic fractures experience increased length of stay, ICU admissions and mortality

Southam¹,

Bowers²,

Smidt³

et al. 2020

Open J Trauma

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Obesity is associated with increased postoperative complications after operative management of distal humerus fractures

Abstract: Obesity is associated with significantly higher rates of complications after ORIF and TEA for distal humerus fractures than in nonobese patients.

Cited by 32 publications

References 37 publications

Analysis of Factors Affecting Return to Work After Surgical Treatment in Patients with AO Type C Distal Humerus Fractures

Analysis of Factors Affecting Return to Work After Surgical Treatment in Patients with AO Type C Distal Humerus Fractures

The Effect of Fat Distribution on the Inflammatory Response of Multiple Trauma Patients—A Retrospective Study

Obese trauma patients who sustain orthopaedic fractures experience increased length of stay, ICU admissions and mortality

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