• Rajshri Maheshwari, Christopher D Mack, Robert P Kaufman, David O Francis, Eileen M Bulger, Sean E Nork, and M Bradford Henley.
• Department of Orthopaedics and Sports Medicine, University ofWashington, 1959 NE Pacific St, PO Box 356500, Seattle, WA 98195, USA. rm15@u.washington.edu
• J Orthop Trauma. 2009 Oct 1; 23 (9): 634-9.

ObjectiveTo understand the influence of obesity on the morbidity and mortality outcomes of patients who have sustained fractures of the femur and tibia.DesignRetrospective review.SettingMulticenter level I trauma facilities.Patients/ParticipantsMotor vehicle crash victims enrolled in multicenter databases were reviewed.Main Outcome MeasurementsOutcome measurements for obese (body mass index, BMI > or = 30 kg/m) versus nonobese (BMI < 30 kg/m) patients included Injury Severity Score, Abbreviated Injury Scores, OTA fracture types, length of hospital stay, disposition, complications, and 36-Item Short Form Survey Instrument.ResultsWe included 665 cases from the database, of which 461 (69%) were nonobese and 204 (31%) were obese. There was no difference in sex, mechanism of injury, Injury Severity Score, and Abbreviated Injury Score. The obese population was older with a mean age of 44 years compared with 41 years for the nonobese (P < 0.01) and had a greater incidence of reported baseline cardiac disease (P < 0.01) and diabetes (P < 0.01). Obese patients had more severe injury patterns (OTA B and C type) in the distal femur fractures (90% versus 61%, P < 0.01). Mortality rates did not show a statistically significant difference (5.6% versus 9.4%, P = 0.07). The baseline physical component on the 36-Item Short Form Survey Instrument was lower among the obese but not statistically different (P = 0.08). At 6 and 12 months post injury, a decline was noted in both groups; however, no differential decline was noted between the groups (P > 0.05).ConclusionsObese patients are significantly more likely to have more severe distal femur fractures compared with nonobese when involved in motor vehicle crashes. In this study, there was no statistically significant difference in length of stay, complications, or mortality in obese patients.

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