Bozzio Anthony E, Gala Raj J, Villasenor Mario A, Hao Jiandon, Mauffrey Cyril
Department of Orthopaedics, University of Colorado School of Medicine, 12631 East 17th Avenue, Mail Stop B202, Room L15-4612, Aurora, CO, 80045, USA.
Eur J Orthop Surg Traumatol. 2014 May;24(4):421-5. doi: 10.1007/s00590-013-1220-3. Epub 2013 Apr 23.
The treatment of morbidly obese patients in orthopedic trauma differs in many ways compared to injured patients with normal body mass indices. This paper highlights key differences and ways to overcome obstacles.
We present specific tips, as well as considerations for initial planning, positioning for surgery, intra-operative strategies, and a discussion on both anesthesia and imaging.
Several treatment strategies have been shown to have better results in morbidly obese patients. Pre-operative planning is necessary for minimizing risk to the patient.
The prevalence of morbid obesity has increased in the USA in the past quarter century. Treatment for orthopedic injuries in morbidly obese patients requires a multidisciplinary approach that addresses not only their orthopedic injuries, but also medical co-morbidities. A team of medicine doctors, anesthesiologists, X-ray technicians, physical and occupational therapists, respiratory therapists, and social workers is needed in addition to the orthopedic surgeon. Modifications in both pre-operative planning and intra-operative strategies may be necessary in order to accommodate the patient. This paper presents numerous technical tips that can aid in providing stable fixation for fractures, as well as addressing peri-operative issues specific to the morbidly obese.
与身体质量指数正常的受伤患者相比，骨科创伤中病态肥胖患者的治疗在许多方面存在差异。本文强调了关键差异以及克服障碍的方法。
我们提供了具体的技巧，以及初始规划、手术定位、术中策略的注意事项，并对麻醉和成像进行了讨论。
已证明几种治疗策略在病态肥胖患者中具有更好的效果。术前规划对于将患者风险降至最低是必要的。
在过去的四分之一世纪里，美国病态肥胖的患病率有所上升。病态肥胖患者的骨科损伤治疗需要多学科方法，不仅要解决他们的骨科损伤，还要解决合并的内科疾病。除了骨科医生外，还需要一组内科医生、麻醉师、X光技师、物理和职业治疗师、呼吸治疗师以及社会工作者。可能需要对术前规划和术中策略进行调整，以适应患者。本文提出了许多技术技巧，有助于为骨折提供稳定固定，以及解决病态肥胖患者特有的围手术期问题。
