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Impact of Increased Body Mass Index on Orthopaedic Trauma Implantology

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Handbook of Orthopaedic Trauma Implantology

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Abstract

Management of long bone fracture in obese patients needs extra surgical care. Obese patients are susceptible to more complications in pre-operative, intra-operative and post-operative period. Special attention of intra-operative implant selection is advisable for these patients, which depends on multiple factors including bone quality, type of trauma, long bone involved and fracture pattern. Paediatric obese patients too need specific implants whether for fracture management or for physeal growth manipulation.

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References

  1. Centers for Disease Control and Prevention. Defining overweight and obesity. Updated 2010 June 21. http://www.cdc.gov/obesity/defining.html. Accessed 27 Feb 2011.

  2. WHO. Obesity and overweight. 9 June 2021. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Accessed 16 Jan 2023.

  3. McCarthy LH, Bigal ME, Katz M, Derby C, Lipton RB. Chronicpain andobesityin elderly people: results from the Einstein aging study. J Am Geriatr Soc. 2009;57(1):115–9. Epub 2008 Nov 19.

    Article  PubMed  Google Scholar 

  4. Ostbye T, Dement JM, Krause KM. Obesity and workers’ compensation: results from the Duke Health and Safety Surveillance System. Arch Intern Med. 2007;167(8):766–73.

    Article  PubMed  Google Scholar 

  5. Pollack KM, Sorock GS, Slade MD, Cantley L, Sircar K, Taiwo O, Cullen MR. Association between body mass index and acute traumatic workplace injury in hourly manufacturing employees. Am J Epidemiol. 2007;166(2):204–11. Epub 2007 May 7.

    Article  PubMed  Google Scholar 

  6. Streubel PN, Gardner MJ, Ricci WM. Management of femur shaft fractures in obese patients. Orthop Clin. 2011;42(1):21–35.

    Google Scholar 

  7. Sabharwal S, Root MZ. Impact of obesity on orthopaedics. JBJS. 2012;94(11):1045–52.

    Article  Google Scholar 

  8. Jones CB. Management of upper extremity injuries in obese patients. Orthop Clin. 2011;42(1):11–9.

    Google Scholar 

  9. Khosla S, Atkinson EJ, Riggs BL, Melton LJ III. Relationship between body composition and bone mass in women. J Bone Miner Res. 1996;11(6):857–63.

    Article  CAS  PubMed  Google Scholar 

  10. De Laet C, Kanis JA, Odén A, Johanson H, Johnell O, Delmas P, Eisman JA, Kroger H, Fujiwara S, Garnero P, McCloskey EV. Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int. 2005;16(11):1330–8.

    Article  PubMed  Google Scholar 

  11. Savvidis C, Tournis S, Dede AD. Obesity and bone metabolism. Hormones. 2018;17(2):205–17.

    Article  PubMed  Google Scholar 

  12. Cao JJ. Effects of obesity on bone metabolism. J Orthop Surg Res. 2011;6(1):1–7.

    Article  Google Scholar 

  13. Beresford JN, Bennett JH, Devlin C, Leboy PS, Owen ME. Evidence for an inverse relationship between the differentiation of adipocytic and osteogenic cells in rat marrow stromal cell cultures. J Cell Sci. 1992;102(Pt 2):341–51.

    Article  CAS  PubMed  Google Scholar 

  14. Gregoire FM, Smas CM, Sul HS. Understanding adipocyte differentiation. Physiol Rev. 1998;78(3):783–809.

    Article  CAS  PubMed  Google Scholar 

  15. Mundy GR. Osteoporosis and inflammation. Nutr Rev. 2007;65(12 Pt 2):S147–51.

    Article  PubMed  Google Scholar 

  16. Wellen KE, Hotamisligil GS. Obesity-induced inflammatory changes in adipose tissue. J Clin Invest. 2003;112(12):1785–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Meunier P, Aaron J, Edouard C, Vignon G. Osteoporosis and the replacement of cell populations of the marrow by adipose tissue. A quantitative study of 84 iliac bone biopsies. Clin Orthop Relat Res. 1971;80:147–54.

    Article  CAS  PubMed  Google Scholar 

  18. Moerman EJ, Teng K, Lipschitz DA, Lecka-Czernik B. Aging activates adipogenic and suppresses osteogenic programs in mesenchymal marrow stroma/stem cells: the role of PPAR-gamma2 transcription factor and TGF-beta/BMP signaling pathways. Aging Cell. 2004;3(6):379–89.

    Article  CAS  PubMed  Google Scholar 

  19. Jensen AT, Rasmussen S. Being overweight and multiple fractures are indications for operative treatment of humeral shaft fractures. Injury. 1995;26(4):263–4.

    Article  CAS  PubMed  Google Scholar 

  20. Wallny T, Sagebiel C, Westerman K, Wagner UA, Reimer M. Comparative results of bracing and interlocking nailing in the treatment of humeral shaft fractures. Int Orthop. 1998 Jan;21(6):374–9.

    Article  PubMed Central  Google Scholar 

  21. Jones CB. Management of upper extremity injuries in obese patients. Orthop Clin North Am. 2011;42(1):11–9, v. https://doi.org/10.1016/j.ocl.2010.08.002.

    Article  PubMed  Google Scholar 

  22. Denies E, Nijs S, Sermon A, Broos P. Operative treatment of humeral shaft fractures. Comparison of plating and intramedullary nailing. Acta Orthop Belg. 2010;76(6):735.

    PubMed  Google Scholar 

  23. Kow RY, Ab Rahman Z, Kumar RJ, Mustapha ZA, Low CL. Management of a failed femoral plate in an obese patient: a case report. Int J Sci Med Educ. 2017:39–42.

    Google Scholar 

  24. Rodriguez EK, Boulton C, Weaver MJ, Herder LM, Morgan JH, Chacko AT, Appleton PT, Zurakowski D, Vrahas MS. Predictive factors of distal femoral fracture nonunion after lateral locked plating: a retrospective multicenter case-control study of 283 fractures. Injury. 2014;45(3):554–9.

    Article  PubMed  Google Scholar 

  25. Aneja A, Yang E, Briscoe M, Graves ML, Porter SE, Bergin P, Russell GV. Intramedullary nailing of femur fractures in the obese: a retrospective comparison of patients with normal weight versus the obese. Austin J Trauma Treat. 2014;1(1):5.

    Google Scholar 

  26. McKee MD, Waddell JP. Intramedullary nailing of femoral fractures in morbidly obese patients. J Trauma. 1994;36:208–10.

    Article  CAS  PubMed  Google Scholar 

  27. Ostrum RF. A greater trochanteric insertion site for femoral intramedullary nailing in lipomatous patients. Orthopedics. 1996;19:337–40.

    Article  CAS  PubMed  Google Scholar 

  28. Tucker MC, Schwappach JR, Leighton RK, Coupe K, Ricci WM. Results of femoral intramedullary nailing in patients who are obese versus those who are not obese: a prospective multicenter comparison study. J Orthop Trauma. 2007;21:523–9.

    PubMed  Google Scholar 

  29. Weinlein JC, Deaderick S, Murphy RF. Morbid obesity increases the risk for systemic complications in patients with femoral shaft fractures. J Orthop Trauma. 2015;29(3):e91–5.

    Article  PubMed  Google Scholar 

  30. Burghardt RD, Specht SC, Herzenberg JE. Mechanical failures of eight-plate guided growth system for temporary hemiepiphysiodesis. J Pediatr Orthop. 2010;30:594–7.

    Article  PubMed  Google Scholar 

  31. Parratte S, Pesenti S, Argenson JN. Obesity in orthopedics and trauma surgery. Orthop Traumatol Surg Res. 2014;100(1):S91–7.

    Article  CAS  PubMed  Google Scholar 

  32. Denzer C, Weibel A, Muche R, Karges B, Sorgo W, Wabitsch M. Pubertal development in obese children and adolescents. Int J Obes. 2007;31(10):1509–19. Epub 2007 Jul 24

    Article  CAS  Google Scholar 

  33. Vignolo M, Naselli A, Di Battista E, Mostert M, Aicardi G. Growth and development in simple obesity. Eur J Pediatr. 1988;147(3):242–4.

    Article  CAS  PubMed  Google Scholar 

  34. Saseendar S, Menon J, Patro DK. Complications and failures of titanium elastic nailing in pediatric femur fractures. Eur J Orthop Surg Traumatol. 2010;20:635–44. https://doi.org/10.1007/s00590-010-0637-1.

    Article  Google Scholar 

  35. Hutchinson R. Are stainless steel elastic nails the solution to heavier children with femoral shaft fractures? Arch Trauma Res. 2019;8:87–92.

    Article  Google Scholar 

  36. Mehlman CT, Bishai SK. Tibial nails for femoral shaft fractures in large adolescents with open femoral physes. J Trauma. 2007;63(2):424–8.

    PubMed  Google Scholar 

  37. McIntosh AL, Hanson CM, Rathjen KE. Treatment of adolescent tibia vara with hemiepiphysiodesis: risk factors for failure. J Bone Joint Surg Am. 2009;91(12):2873–9.

    Article  PubMed  Google Scholar 

  38. Schroerlucke S, Bertrand S, Clapp J, Bundy J, Gregg FO. Failure of Orthofix eight Plate for the treatment of Blount disease. J Pediatr Orthop. 2009;29(1):57–60.

    Article  PubMed  Google Scholar 

  39. Burrus MT, Werner BC, Yarboro SR. Obesity is associated with increased postoperative complications after operative management of tibial shaft fractures. Injury. 2016;47(2):465–70.

    Article  PubMed  Google Scholar 

  40. Leet AI, Pichard CP, Ain MC. Surgical treatment of femoral fractures in obese children: does excessive body weight increase the rate of complications? J Bone Joint Surg Am. 2005;87-A:2609–13.

    Google Scholar 

  41. Novais EN, Potter GD, Sierra RJ, et al. Surgical treatment of adolescent acetabular dysplasia with a periacetabular osteotomy: does obesity increase the risk of complications? J Pediatr Orthop. 2015;35:561–4.

    Article  PubMed  Google Scholar 

  42. Weiss JM, Choi P, Ghatan C, Skaggs DL, Kay RM. Complications with flexible nailing of femur fractures more than double with child obesity and weight >50 kg. J Child Orthop. 2009;3(1):53–8. Epub 2008 Dec 10.

    Article  PubMed  Google Scholar 

  43. Moroz LA, Launay F, Kocher MS, Newton PO, Frick SL, Sponseller PD, Flynn JM. Titanium elastic nailing of fractures of the femur in children. Predictors of complications and poor outcome. J Bone Joint Surg Br. 2006;88(10):1361–6.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India

    Saseendar Shanmugasundaram & S. Samundeeswari

  2. King Hamad University Hospital, Al Sayh, Bahrain

    Atul Bandi

  3. International Training Fellow (Hip & Knee)-Department of Trauma and Orthopaedics, Russells Hall Hospital, Dudley, West Midlands, England

    Debabrata Kumar

Authors
  1. Saseendar Shanmugasundaram
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  2. Atul Bandi
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  3. S. Samundeeswari
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  4. Debabrata Kumar
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Corresponding author

Correspondence to Saseendar Shanmugasundaram .

Editor information

Editors and Affiliations

  1. NH Narayana Superspeciality and Multispeciality Hospitals, Howrah, West Bengal, India

    Arindam Banerjee

  2. Technical University of Munich, Munich, Germany

    Peter Biberthaler

  3. Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India

    Saseendar Shanmugasundaram

Section Editor information

  1. Orthopaedic Surgery, NH Narayana Superspeciality and Multispeciality Hospitals, Howrah, West Bengal, India

    Arindam Banerjee

  2. International Training Fellow(Hip & Knee)-Dept of Trauma & Orthopaedics, Russells Hall Hospital, Dudley, West Midlands, England

    Debabrata Kumar

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Shanmugasundaram, S., Bandi, A., Samundeeswari, S., Kumar, D. (2023). Impact of Increased Body Mass Index on Orthopaedic Trauma Implantology. In: Banerjee, A., Biberthaler, P., Shanmugasundaram, S. (eds) Handbook of Orthopaedic Trauma Implantology. Springer, Singapore. https://doi.org/10.1007/978-981-19-7540-0_54

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  • DOI: https://doi.org/10.1007/978-981-19-7540-0_54

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-7539-4

  • Online ISBN: 978-981-19-7540-0

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