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Does local fat thickness correlate with post-operative infection in open reduction and internal fixation of acetabulum fractures?

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Obesity is an epidemic which increases risk of many surgical procedures. Previous studies in spine and hip arthroplasty have shown that fat thickness measured on preoperative imaging may be as or more reliable in assessment of risk of post-operative infection and/or wound complications than body mass index (BMI). We hypothesized that, similarly, increased local fat thickness at the surgical site is a predictor of wound complication in acetabulum fracture surgery.

Methods

Patients who underwent open reduction and internal fixation (ORIF) of an acetabulum fracture through a Kocher-Langenbeck (K-L) approach at a single institution from 2013 to 2020 were identified. Pre-operative CT scans were used to measure fat thickness from the skin to the greater trochanter in line with the surgical approach. Post-operative infections and wound complications were recorded and associated with fat thickness and BMI.

Results

238 patients met inclusion criteria. 12 patients had either infection or a wound complication (5.0%). There was no significant association with BMI or preoperative fat thickness on post-operative infection or wound complication (p-value 0.73 and 0.86).

Conclusions

There is no statistically significant association of post-operative infection or wound complications in patients with increased soft tissue thickness or increased BMI. ORIF of acetabulum fractures through a K-L approach can be performed safely in patients with large subcutaneous fat thickness and high BMI with low risk of infection or wound complications.

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Funding

No external funding was used in this study.

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Authors and Affiliations

  1. Department of Orthopaedic Trauma and Reconstructive Surgery, Ohio Health Grant Medical Center, 285 E State St, Suite 500, Columbus, OH, 43215, USA

    Jack W. Weick

  2. McGovern Medical School at UTHealth, Houston, TX, USA

    Reese A. Svetgoff, Jacob J. Siahaan, Ryan P. Bailey & Daniel J. Walsh

  3. Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA

    Mitchel R. Obey

  4. Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, Houston, TX, USA

    Jonathan G. Eastman, Milton L. Chip Routt & Stephen J. Warner

Authors
  1. Jack W. Weick
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  2. Reese A. Svetgoff
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  3. Mitchel R. Obey
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  4. Jacob J. Siahaan
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  5. Ryan P. Bailey
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  6. Daniel J. Walsh
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  7. Jonathan G. Eastman
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  8. Milton L. Chip Routt
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  9. Stephen J. Warner
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Corresponding author

Correspondence to Jack W. Weick.

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Conflict of interest

Jack Weick reports the following: Orthopaedic Trauma Association, board or committee member. Jonathan Eastman reports the following: AO North America, board or committee member; Globus Medical, paid consultant; Osteocentric, IP royalties; Stryker, paid consultant. Milton L. Chip Routt reports the following: AO North America, board or committee member, paid presenter or speaker; Johnson & Johnson, paid presenter or speaker; Stryker, paid presenter or speaker; Zimmer, paid presenter or speaker. Stephen Warner reports the following: AAOS, board or committee member; AO North America, board or committee member; Globus Medical, paid consultant, paid presenter or speaker; Orthopaedic Trauma Association, board or committee member; Smith & Nephew, paid presenter or speaker; Stryker, paid consultant, paid presenter or speaker. Remainder of authors have nothing to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Weick, J.W., Svetgoff, R.A., Obey, M.R. et al. Does local fat thickness correlate with post-operative infection in open reduction and internal fixation of acetabulum fractures?. Eur J Orthop Surg Traumatol 34, 2049–2054 (2024). https://doi.org/10.1007/s00590-024-03892-z

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  • DOI: https://doi.org/10.1007/s00590-024-03892-z

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