The Effects of Obesity on Trauma and Surgical Outcomes

There are times that we simply cannot avoid significant trauma that requires orthopedic intervention, either emergently or urgently. And, unfortunately, obesity has a significant effect on virtually every aspect of trauma recovery and surgery.

A 2015 American Academy of Orthopedic Surgeons position statement¹ offers a number of very concerning problems associated with obesity and trauma such as a motor vehicle accident or blunt trauma. The position statement concludes that obese patients have an increased risk of medical complications, longer hospital stays, increase in mortality, higher likelihood of multi-organ failure, higher risk of hardware failure, slower wound healing and an increased risk of deep vein thrombosis or DVT. Further, even the accuracy of common imaging such as MRI, CT, X-ray used to diagnose traumatic injuries can be compromised by excess weight and obesity.

Sadly, obese children are not free of the effects of their excess weight either. Children suffering from obesity not only have a greater chance of sustaining lower extremity injuries and resulted pain when compared to normal BMI children but, they are more likely to have fractures near a joint such as the wrist area, shin bone area and thigh bone area.

A 2018 study² further showed the complexities experienced in the treatment of obese patients for trauma. The number of days required in intensive care units and on mechanical ventilation was found to be significantly greater for obese versus normal weight patients. Kidney injury and infections were seen more often in obese patients as well. Even the surgery itself may take longer and require specialized equipment.

With that being said, it is important to remember that proper orthopedic care for any kind of trauma is extremely important. Many trauma cases can be resolved with conservative care such as anti-inflammatory medication, rest, icing and heat, and physical therapy. However, for those cases that do require surgery, orthopedic surgery is very successful. However, it is worth noting, that the outcomes may not be as favorable for patients suffering from obesity.

References:

• ¹ A. (2015, March). The Impact of Obesity on Bone and Joint Health [PDF]. Chicago, Illinois: American Academy of Orthopaedic Surgeons.
• ² Gray S, Dieudonne B. Optimizing Care for Trauma Patients with Obesity. Cureus. 2018;10(7):e3021. Published 2018 Jul 22. doi:10.7759/cureus.3021