Assuntos
Reforma dos Serviços de Saúde , Política de Saúde , Especialidade de Fisioterapia , Saúde Pública , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Necessidades e Demandas de Serviços de Saúde , Programas Gente Saudável , Humanos , Masculino , Pessoa de Meia-Idade , National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division , Patient Protection and Affordable Care Act , Estados UnidosRESUMO
OBJECTIVES: To evaluate the radiographic and computed tomographic reduction qualities after acetabular fracture repair in obese and nonobese patients. DESIGN: Retrospective review. SETTING: University medical center. PATIENTS/PARTICIPANTS: Two hundred forty-two patients were treated with open reduction internal fixation for displaced acetabular fractures. The nonobese group (Group 1) consisted of 149 patients and the obese group (Group 2) had 93 patients. A nonmorbidly obese group (Group 3 = 221 patients) and a morbidly obese group (Group 4 = 21 patients) were also created from the same patient population. INTERVENTION: Operative repair of acetabular fractures. MAIN OUTCOME MEASUREMENTS: Reductions on postoperative radiographs were classified as anatomic with less than 1 mm, imperfect with 2 to 3 mm, and poor with greater than 3 mm of residual displacement. On postoperative computed tomographic scans, reductions were considered nonanatomic with persistent gap or step displacements greater than or equal to 2 mm. RESULTS: Anatomic radiographic reductions were achieved in 72% of the nonobese patients, 70% of the obese patients, 72% of the nonmorbidly obese patients, and 61% of the morbidly obese patients. (P = 0.379) On postoperative computed tomographic scans, an acceptable reduction was obtained in 47% of the nonobese patients, 44% of the obese patients, 47% of the nonmorbidly obese patients, and 31% of the morbidly obese patients. (P = 0.232). CONCLUSIONS: Anatomic or satisfactory reductions can be similarly achieved in all classes of nonmorbidly obese patients who have sustained displaced acetabular fractures. In the morbidly obese, anatomic reductions may be more difficult to obtain.