I.F. AKHTYAMOV^1, 2, H.Ch. HAN¹, S.A. ARDASHEV^{1, 2}, A.L. EMELIN^1,2

¹Kazan State Medical University, Kazan

²Republic Clinical Hospital, Kazan

 Contact details:

Akhtyamov I.F. — MD, Professor, Head of the Department of Traumatology, Orthopedics and SES

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7 (843) 222-22-22, e-mail: yalta60@mail.ru

 The purpose — to investigate the efficiency of surgical treatment of proximal femur fractures in obese elderly patients.

Material and methods. We conducted a prospective analysis of the treatment outcomes of 230 patients aged 60 to 93 years between 2016 and 2019. 115 patients with proximal trochanteric fractures underwent arthroplasty and 115 patients with similar fractures were treated with the method of intramedullary blocked osteosynthesis.

Conclusion. As shown by our experience in the treatment of trochanter femoral fractures using intramedullary pin and arthroplasty in obese patients, at the inpatient stage of treatment there are no fundamental differences (limitations) with patients with normal body weight. We believe that the use of both methods can improve the postoperative function of the hip joint. However, the overall positive outcome of the treatment of obese patients leaves no doubt about the need for joint replacement in case of indications in this group, taking into account the increased risk of complications in the studied group of patients and provided that possible intra- and postoperative risks are prevented.

Key words: proximal femur fracture, obesity, endoprosthetics, intramedullary blocked osteosynthesis.

REFERENCES

1. Canoy D., Cairns B.J., Balkwill A. et al. Women Study Collaborators. Coronary heart disease incidence in women by waist circumference within categories of body mass index. Eur J Prev Cardiol, 2013, vol. 20 (5), pp. 759–762.
2. Canoy D., Cairns B.J., Balkwill A. et al. Body mass index and incident coronary heart disease in women: a population-based prospective study. BMC Med, 2013, vol. 11, p. 87.
3. Yang H., Wang Y., Negishi K. et al. Pathophysiological effects of different risk factors for heart failure. Open Heart, 2016, vol. 3, p. e000339.
4. Bhaskaran K., Douglas I., Forbes H. et al. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5·24 million UK adults. Lancet, 2014, vol. 384 (9945), pp. 755–765.
5. Carnethon M.R., De Chavez P.J., Biggs M.L. et al. Association of weight status with mortality in adults with incident diabetes. JAMA, 2012, vol. 308 (6), pp. 581–590.
6. Sambandam S.N., Chandrasekharan J., Mounasamy V., Mauffrey C. Intertrochanteric fractures: a review of fixation methods. Eur J Orthop Surg Traumatol, 2016, vol. 26 (4), pp. 339–353.
7. Wise K., Blaschke B.L., Parikh H.R. et al. Variation of the Inpatient Cost of Care in the Treatment of Isolated Geriatric Intertrochanteric Hip Fractures. Geriatr Orthop Surg Rehabil., 2020, vol. 11.
8. Morris A.H., Zuckerman J.D. National Consensus Conference on Improving the Continuum of Care for Patients with Hip Fracture. Journal of Bone & Joint Surgery American, 2002, vol. 84-A (4), p. 670.
9. Deribew A., Oja l.J., Karia B. et al. Under-five mortality rate variation between the Health and Demographic Surveillance System (HDSS) and Demographic and Health Survey (DHS) approaches. Bmc Public Health, 2016, vol. 16 (1), p. 1118.
10. Prokhorenko V.M. Pervichnoe i revizionnoe endoprotezirovanie tazobedrennogo sustava [Primary and revision hip arthroplasty]. Novosibirsk: ANO «Klinika NIITO», 2007. 48 p.
11. Tikhilova R.M., Shubnyakova I.I. Rukovodstvo po khirurgii tazobedrennogo sustava [Guidelines for hip surgery]. Saint Petersburg: RNIITO im. R.R. Vredena, 2015. No. 2. P. 356.
12. Akhtyamov I.F., Khan’ Kh.Ch., Fayzrakhmanova G.M. et al. Hip arthroplasty in obese patients (a meta-analysis of prospective cohort studies). Travmatologiya i ortopediya Rossii, 2019, no. 25 (1), pp. 177–187 (in RTuss.).
13. Vasarhelyi E.M., MacDonald S.J. The influence of obesity on total joint arthroplasty. J Bone Joint Surg (Br), 2012, vol. 94 (11 Suppl A), pp. 100.
14. World Health Organization. Obesity: Preventing and managing the global epidemic. Report of a who consultation. World Health Organ. Tech. Rep. Ser, 2000, vol. 894, pp. 1–253.
15. Feng S.Y., Xu J.G., Wang Q.C. et al. The relationship between obesity and limb fracture healing. Medium National Journal of Bone and Joint Injury, 2007, vol. 22 (7), p. 585.