title: Orthopedic trauma surgery in the morbidly obese patient.
abstract: OBJECTIVE
  The treatment of morbidly obese patients in orthopedic trauma differs in many ways compared to injured patients with normal body mass indices. This paper highlights key differences and ways to overcome obstacles.
  
  
  METHODS
  We present specific tips, as well as considerations for initial planning, positioning for surgery, intra-operative strategies, and a discussion on both anesthesia and imaging.
  
  
  RESULTS
  Several treatment strategies have been shown to have better results in morbidly obese patients. Pre-operative planning is necessary for minimizing risk to the patient.
  
  
  CONCLUSIONS
  The prevalence of morbid obesity has increased in the USA in the past quarter century. Treatment for orthopedic injuries in morbidly obese patients requires a multidisciplinary approach that addresses not only their orthopedic injuries, but also medical co-morbidities. A team of medicine doctors, anesthesiologists, X-ray technicians, physical and occupational therapists, respiratory therapists, and social workers is needed in addition to the orthopedic surgeon. Modifications in both pre-operative planning and intra-operative strategies may be necessary in order to accommodate the patient. This paper presents numerous technical tips that can aid in providing stable fixation for fractures, as well as addressing peri-operative issues specific to the morbidly obese.
authors.affiliation: Department of Orthopaedics, University of Colorado School of Medicine, 12631 East 17th Avenue, Mail Stop B202, Room L15-4612, Aurora, CO, 80045, USA.
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Bozzio
authors.forename: Raj J
authors.initials: RJ
authors.lastname: Gala
authors.forename: Mario A
authors.initials: MA
authors.lastname: Villasenor
authors.forename: Jiandon
authors.initials: J
authors.lastname: Hao
authors.forename: Cyril
authors.initials: C
authors.lastname: Mauffrey
mesh_terms: D000768:Anesthesia, General / Q000379:methods; D019072:Antibiotic Prophylaxis / Q000379:methods; D050723:Fractures, Bone / Q000150:complications* / Q000601:surgery*; D006801:Humans; D009767:Obesity, Morbid / Q000150:complications*; D019637:Orthopedic Procedures / Q000295:instrumentation* / Q000379:methods*; D056888:Patient Positioning / Q000379:methods; D014947:Wounds and Injuries / Q000150:complications / Q000601:surgery