Percutaneous treatment of pelvic and acetabular fractures in obese patients.

A body mass index (BMI) greater than 30 is becoming increasingly common in the United States. Surgery for pelvic and acetabular fractures in this population is particularly problematic because conventional treatment often requires large surgical exposures. The surgery for both these fractures is technically difficult because of the volume of soft tissue and proneness to complications. Wound problems and infections are particularly common after open surgery in obese patients, and these increase linearly with the BMI. In this article, we present a small consecutive series over 14 months on obese patients who underwent percutaneous treatment of their pelvic or acetabular fractures.

[1]  P. Tornetta,et al.  Outcome of operatively treated unstable posterior pelvic ring disruptions. , 1996, Clinical orthopaedics and related research.

[2]  K. Flegal,et al.  Prevalence of high body mass index in US children and adolescents, 2007-2008. , 2010, JAMA.

[3]  J. Matta.  Fractures of the Acetabulum: Accuracy of Reduction and Clinical Results in Patients Managed Operatively within Three Weeks after the Injury* , 1996, The Journal of bone and joint surgery. American volume.

[4]  P. Parker,et al.  Percutaneous fluoroscopic screw fixation of acetabular fractures. , 1997, Injury.

[5]  A. Starr,et al.  Reduction of Displaced Pelvic Ring Disruptions Using a Pelvic Reduction Frame , 2009, Journal of orthopaedic trauma.

[6]  A J Starr,et al.  Early experience with reduction of displaced disruption of the pelvic ring using a pelvic reduction frame. , 2009, The Journal of bone and joint surgery. British volume.

[7]  G. Russell,et al.  Operative Experience of Pelvic Fractures in the Obese , 2008, Obesity surgery.

[8]  S. Jerabek,et al.  Body mass index as a predictor of complications after operative treatment of acetabular fractures. , 2005, The Journal of bone and joint surgery. American volume.

[9]  N. Jouriles.  Pelvic fractures: Value of plain radiography in early assessment and management , 1987 .

[10]  D. Griffin,et al.  Vertically Unstable Pelvic Fractures Fixed with Percutaneous Iliosacral Screws: Does Posterior Injury Pattern Predict Fixation Failure? , 2003, Journal of orthopaedic trauma.

[11]  T. Bhattacharyya,et al.  Perioperative Management of the Obese Orthopaedic Patient , 2006, The Journal of the American Academy of Orthopaedic Surgeons.

[12]  T. Scalea,et al.  Impact of obesity in the critically ill trauma patient: a prospective study. , 2006, Journal of the American College of Surgeons.

[13]  P. Beaulé.  A modified anterior exposure to the acetabulum for treatment of difficult anterior acetabular fractures. , 2009, Journal of orthopaedic trauma.

[14]  R. Brumback,et al.  A modified extensile exposure for the treatment of complex or malunited acetabular fractures. , 1988, The Journal of bone and joint surgery. American volume.

[15]  P. Rhee,et al.  The impact of obesity on the outcomes of 1,153 critically injured blunt trauma patients. , 2005, The Journal of trauma.

[16]  P. Dubbert,et al.  Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. , 2006, The American journal of the medical sciences.

[17]  K. Mayo.  Open reduction and internal fixation of fractures of the acetabulum. Results in 163 fractures. , 1994, Clinical orthopaedics and related research.

[18]  C. Roberts,et al.  Percutaneous fixation of the pelvic ring: an update. , 2007, The Journal of bone and joint surgery. British volume.

[19]  D. Laverty,et al.  Fractures of the Pelvis and Acetabulum , 2004 .

[20]  S. Nork,et al.  Perioperative complications associated with operative treatment of acetabular fractures. , 2001, The Journal of trauma.

[21]  M. Goldberg,et al.  Validity of self-reported weight and height in the French GAZEL cohort , 2000, International Journal of Obesity.

[22]  L. Weireter,et al.  Obesity and increased mortality in blunt trauma. , 1991, The Journal of trauma.

[23]  Romney C Andersen,et al.  Modified Stoppa Approach for Acetabular Fractures With Anterior and Posterior Column Displacement: Quantification of Radiographic Reduction and Analysis of Interobserver Variability , 2010, Journal of orthopaedic trauma.

[24]  D. Templeman,et al.  Elevated Body Mass Index Increases Early Complications of Surgical Treatment of Pelvic Ring Injuries , 2010, Journal of orthopaedic trauma.

[25]  A J Starr,et al.  Preliminary results and complications following limited open reduction and percutaneous screw fixation of displaced fractures of the acetabulum. , 2001, Injury.

[26]  K. Flegal,et al.  Prevalence and trends in obesity among US adults, 1999-2008. , 2010, JAMA.

[27]  B. Boulanger,et al.  Body habitus as a predictor of injury pattern after blunt trauma. , 1992, The Journal of trauma.

[28]  Emile Letournel,et al.  Fractures of the Acetabulum , 1981, Springer Berlin Heidelberg.