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Morbid obesity quadruples acetabular fracture complication rate

Patients with a body mass index greater than 40 had longer operating times and postop hospitalizations, researchers found.

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PHOENIX — Patients with morbid obesity may have a fourfold increase in complications following surgery for acetabular fractures, a study suggests.

George Russell, MD, and colleagues at the University of Mississippi Medical Center in Jackson, Miss., compared complication rates between morbidly obese and non-obese patients who underwent open reduction and internal fixation for displaced acetabular fractures. The researchers prospectively gathered data from a database of 349 patients. Of these patients, 39 had morbid obesity, defined as a Body Mass Index of 40 or higher.

Russell presented the results at the Orthopaedic Trauma Association Annual Meeting, here.

The researchers found that morbidly obese patients had a 67% complication rate compared to a 16% complication rate among non-obese patients. Morbidly obese patients also experienced significantly more blood loss (P<.044), had longer operative times (P<.08) and longer hospital stays (P<.008), according to the study.

"It would be easy for me to answer the question [Is operative treatment worth the risk?] by saying no, I would not operate on these patients anymore. But, I think that is tremendously shortsighted given the fact that the patients are coming and obesity is growing at a very rapid rate," Russell said.

Among morbidly obese patients, researchers found nine failures during the 6- to 48-month follow-up. "Six of those have gone on to total hip arthroplasty and of those six, two have required a revision total hip arthroplasty," Russell said, noting most failures had ventilation problems and comminuted posterior wall fractures.

Additionally, 13 morbidly obese patients had wound problems, including eight deep infections, requiring additional procedures, according to the study.

For more information:

• Russell G, Dews R, Graves M. Morbid obesity: Is operative treatment of displaced acetabular fractures worth the risk? #41. Presented at the Orthopaedic Trauma Association 22nd Annual Meeting. Oct. 4-7, 2006. Phoenix.