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. 2023 Jan;143(1):373-379.
doi: 10.1007/s00402-022-04338-z. Epub 2022 Jan 20.

Patient obesity is associated with severity of proximal humerus fractures, not outcomes

Blake I Boadi  1 , Rebekah Belayneh  1 , Connor P Littlefield  1 , Kenneth A Egol  2
Affiliations

Patient obesity is associated with severity of proximal humerus fractures, not outcomes

Blake I Boadi et al. Arch Orthop Trauma Surg. 2023 Jan.

Abstract

Purpose: The purpose of this study is to evaluate the effect of obesity on the outcome of operatively treated proximal humerus fractures.

Methods: Between December 2003 and October 2020, 240 patients with proximal humerus fractures requiring surgery were prospectively followed and classified according to the international AO/Orthopedic Trauma Association (AO/OTA) and Neer classifications. Patients' body mass indexes (BMI) were calculated and used to identify two groups, BMI ≥ 30 kg/cm (obese) and < 30 kg/cm (non-obese). Independent t tests were used for statistical analysis of continuous variables and χ2 tests for categorical variables. Regression analysis was performed to determine if BMI was a predictor of fracture pattern severity as determined by the AO/OTA classification.

Results: Overall, 223 patients who sustained proximal humerus fractures were analyzed. Patient age at time of injury was 60.5 ± 13.7 years. There were 67 AO/OTA 11A, 79 AO/OTA 11B, and 77 AO/OTA 11C fracture types. Seventy-two patients (32.3%) were obese. No significant differences were seen between groups in regard to demographic variables, Neer classification, or functional and clinical outcomes as determined by DASH scores and shoulder ROM, respectively. Statistical analyses confirmed that obesity is associated with more severe fracture patterns of the proximal humerus as categorized by the AO/OTA classification. An independent t test confirmed that BMI was significantly higher in the complex fracture group based on the AO/OTA classification (p = 0.047). Regression analysis also demonstrated that age (p = 0.005) and CCI (p = 0.021) were predictors of more severe fractures, while BMI approached significance (p = 0.055) based on the AO/OTA classification.

Conclusion: A significantly higher incidence of complex proximal humerus fracture patterns is observed in patients with higher body mass indexes based on the AO/OTA classification. Age and CCI are also associated with more severe fracture patterns of the proximal humerus as determined by the AO/OTA classification. No differences were seen in outcomes or complication rates between obese patients and non-obese patients.

Level of evidence: Level III.

Keywords: Fracture severity; Obesity; Outcomes; Proximal humerus fracture.

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References

    1. Flegal KM, Carroll MD, Kit BK, Ogden CL (2012) Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA 307(5):491–497. https://doi.org/10.1001/jama.2012.39 - DOI
    1. World Health Organization. Obesity and overweight [Internet]. 2018 Feb 16 [cited 2019 Nov 6]. http://www.who.int/mediacentre/factsheets/fs311/en/ . Accessed 12 July 2021
    1. Parratte S, Pesenti S, Argenson JN (2014) Obesity in orthopedics and trauma surgery. Orthop Traumatol Surg Res 100(1 Suppl):S91–S97. https://doi.org/10.1016/j.otsr.2013.11.003 - DOI
    1. Berry PA, Jones SW, Cicuttini FM, Wluka AE, Maciewicz RA (2011) Temporal relationship between serum adipokines, biomarkers of bone and cartilage turnover, and cartilage volume loss in a population with clinical knee osteoarthritis. Arthritis Rheum 63(3):700–707. https://doi.org/10.1002/art.30182 - DOI
    1. Conde J, Scotece M, López V, Gómez R, Lago F, Pino J et al (2013) Adipokines: novel players in rheumatic diseases. Discov Med 15(81):73–83

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