Sardesai Neil R, Miller Michael A, Jauregui Julio J, Griffith Cullen K, Henn R Frank, Nascone Jason W
Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD, USA,
Orthop Res Rev. 2017 Aug 7;9:75-81. doi: 10.2147/ORR.S113424. eCollection 2017.
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.
在本综述中，我们旨在增进对肥胖患者群体髋臼骨折治疗的了解。美国肥胖症的极高发病率是一个迫在眉睫的医疗保健问题，影响着所有医学专科的医疗保健各个方面。在为肥胖患者治疗髋臼骨折时，骨科医生有特定的关注点。体重指数≥30的患者在既有医疗状况、诊断成像和围手术期并发症方面给外科医生带来了特殊挑战。具体而言，该患者群体的功能结局较差，手术部位感染、术中失血、深静脉血栓形成、创伤后骨关节炎、异位骨化的发生率更高，且住院时间延长。在病态肥胖患者中，这些问题会进一步加剧，因为体重指数增加与并发症情况恶化之间存在比例效应。鉴于美国目前病态肥胖的高发病率，这是个问题，而考虑到未来肥胖率预计还会上升，尤其令人担忧。
