The American journal of orthopedics
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Osteoarthritis (OA) has become one of the leading causes of disability in the United States. Mechanical forces exerted on the joints are a significant cause of OA and one of the most modifiable risk factors. As determined by body mass index (BMI), 34 million US adults are obese, and 13 million of these are morbidly obese. ⋯ March and Bagga (Med J Aust. 2004; 180 (5 suppl): S6-S10) showed that the risk for knee OA increased by 36% for every 2 units of BMI (5 kg) of weight gain. Bariatric surgery results in a mean weight loss of 44 kg (97 lb). Eighty-nine percent of patients had complete relief of pain caused by OA in at least one joint after undergoing bariatric surgery.
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Open periarticular shoulder fractures present a tremendous challenge for orthopedic surgeons. These injuries, albeit rare, are typically caused by high-energy mechanisms and are associated with insult to multiple organ systems resulting in high morbidity and mortality. Although the civilian trauma literature includes several articles on outcomes of closed periarticular shoulder fractures, only 1 peer-reviewed article has focused on this specific open injury pattern. ⋯ Meticulous surgical débridement is essential in managing these severely comminuted and contaminated open fractures. In cases in which internal fixation is used, careful timing and patient selection are required to minimize risk for osteomyelitis. Data collection is being continued in this patient cohort to allow for eventual reporting of functional outcomes.