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

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

“…The effect of obesity on orthopedic surgery has received recent attention in the literature, most consistently with lower extremity arthroplasty but more recently in upper extremity surgery including conventional and reverse total shoulder arthroplasty and TEA. [1][2][3]18,29,32,37 Evidence has been lacking with regard to the risk of obesity in the treatment of upper extremity trauma. In this study, we examined a national insurance database for trends in medical and surgical complications after operative treatment of distal humerus fractures.…”

“…18 Recent data regarding ORIF of proximal humerus fractures demonstrated similar results, including a substantial increase in local and systemic complications postoperatively. 37 Obesity is often clustered with other medical comorbidities and thus is difficult to isolate as an independent risk factor. Other studies focus on the metabolic syndrome, defined as a BMI >30 kg/m 2 as well as two of the following: hypertriglyceridemia, hyperlipidemia, diabetes mellitus, or hypertension.…”

Perioperative management of the obese surgical patient

“…126,[128][129][130][131][132][133][134] The already high risk for VTE is further exacerbated with progressively higher BMI, prolonged surgical time, older age, male sex, history of OSA, obesity hypoventilation syndrome and a previous history of VTE. 129;134,135 According to the 2013 Clinical Practice guidelines for bariatric surgical patients, it is recommended that VTE prophylaxis, including sequential compression devices and chemoprophylaxis, to be administered perioperatively.…”

“…Interrogation of the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database showed that in total joint arthroplasty, a BMI > 40 kg/m 2 is an independent predictor for superficial infection. 181 Similarly, obese patients undergoing open reduction and internal fixation of distal humeral fractures or total elbow arthroplasty 132 total ankle arthroplasty or ankle arthrodesis, 131 total shoulder arthroplasty 133 fixation for intertrochanteric femur fractures, 182 and fixation of a fracture of an ankle 183 all have an increased incidence of surgical-site infections when compared to non-obese patients undergoing the same surgery.…”

Morbid obesity and perioperative complications

“…Obesity is recognized as an independent risk factor for perioperative venous thromboembolism (VTE) [29][30][31][32][33][34]. Recent ACS-NSQIP database analysis finds that a BMI at least 40 kg/m 2 significantly increased the odds of VTE after CABG, total hip arthroplasty, colectomy, prostatectomy, and pancreatectomy [6 && ].…”