{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:04:36Z","timestamp":1793138676138,"version":"4.5.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n            <jats:title>OBJECTIVES:<\/jats:title>\n            <jats:p>To evaluate the association between obesity and treatment approaches, perioperative factors, and clinical and radiographic outcomes following subtrochanteric fracture fixation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective Cohort.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Academic Medical Center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patient Selection Criteria:<\/jats:title>\n            <jats:p>Patients operatively treated for an AO\/OTA 32Axa, 32Bxa, or 32Cxa subtrochanteric femur fracture.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Outcome Measures and Comparisons:<\/jats:title>\n            <jats:p>Injury characteristics, perioperative parameters, fixation information, postoperative complications, and clinical and radiographic outcomes. Univariate analyses were conducted between the obese (BMI \u226530 kg\/m<jats:sup>2<\/jats:sup>) and the nonobese (BMI &lt;30 kg\/m<jats:sup>2<\/jats:sup>) cohorts. Regression analyses were performed to assess BMI as a continuous variable.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Of 230 operatively treated subtrochanteric fracture patients identified, 49 (21%) were obese and 181 (79%) were nonobese. The average age of the obese cohort was 69.6 \u00b1 17.2 years, with 16 (33%) male and 33 (77%) female. The average age of the nonobese cohort was 71.8 \u00b1 19.2 years, with 60 (33%) male and 121 (77%) female. Aside from BMI, there were no significant differences in demographics between the obese and nonobese (age [<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.465], sex [<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.948], American Society of Anesthesiology Score [<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.739]). Both cohorts demonstrated similar injury characteristics including mechanism of injury, atypical fracture type, and AO\/OTA fracture pattern (32A, 32B, 32C). Obese patients underwent more open reduction procedures (59% open obese, 11% open nonobese, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001), a finding further quantified by a 24% increased likelihood of open reduction for every 1 unit increase in BMI (OR: 1.2, 95% CI, 1.2\u20131.3, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). There was no difference in average nail diameter, 1 versus 2-screw nail design, or number of locking screws placed. The obese cohort was operated more frequently on a fracture table (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001) when compared with the nonobese cohort that was operated more frequently on a flat table (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). There were no significant differences (<jats:italic toggle=\"yes\">P<\/jats:italic> &gt; 0.050) in postoperative complications, mortality\/readmission rates, hospital quality measures, fixation failure, or time to bone healing.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>The treatment of subtrochanteric fractures in obese patients is associated with a higher likelihood of surgeons opting for open fracture reduction and the use of different operating room table types, but no difference was observed in postoperative complications, mortality or readmission rates, or healing timeline when compared with nonobese patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>LEVEL OF EVIDENCE:<\/jats:title>\n            <jats:p>Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000002813","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T08:10:35Z","timestamp":1712736635000},"page":"366-372","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Subtrochanteric Femur Fractures: The Association Between Obesity and Perioperative, Clinical, and Radiographic Outcomes"],"prefix":"10.1097","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8285-2807","authenticated-orcid":false,"given":"Lauren A.","family":"Merrell","sequence":"first","affiliation":[{"name":"Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kester","family":"Gibbons","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Ganta","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"},{"name":"Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjit R.","family":"Konda","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"},{"name":"Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0341-7683","authenticated-orcid":false,"given":"Kenneth A.","family":"Egol","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"},{"name":"Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1302\/2058-5241.6.200048","article-title":"Subtrochanteric femur fractures: current review of management","volume":"6","author":"Garrison","year":"2021","journal-title":"EFORT Open Rev"},{"key":"R2-20250614","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1186\/s13018-016-0441-7","article-title":"Is early appropriate care of axial and femoral fractures appropriate in multiply-injured elderly trauma patients?","volume":"11","author":"Reich","year":"2016","journal-title":"J Orthop Surg Res"},{"key":"R3-20250614","first-page":"127","article-title":"Subtrochanteric fractures in elderly people: functional and radiographic outcomes after intramedullary locked nail fixation with or without cerclage","volume":"26","author":"Bonfiglio","year":"2022","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"R4-20250614","doi-asserted-by":"crossref","first-page":"38613","DOI":"10.52965\/001c.38613","article-title":"Subtrochanteric femoral fractures: a case series of 194 patients treated with long and short intramedullary nails","volume":"14","author":"Jannelli","year":"2022","journal-title":"Orthop Rev"},{"key":"R5-20250614","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ocl.2014.09.001","article-title":"Contemporary management of subtrochanteric fractures","volume":"46","author":"Joglekar","year":"2015","journal-title":"Orthop Clin North Am"},{"key":"R6-20250614","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1007\/s00198-011-1777-9","article-title":"Trends in subtrochanteric, diaphyseal, and distal femur fractures, 1984-2007","volume":"23","author":"Ng","year":"2012","journal-title":"Osteoporos Int"},{"key":"R7-20250614","doi-asserted-by":"crossref","first-page":"S91","DOI":"10.1016\/j.otsr.2013.11.003","article-title":"Obesity in orthopedics and trauma surgery","volume":"100","author":"Parratte","year":"2014","journal-title":"Orthop Traumatol Surg Res"},{"key":"R8-20250614","doi-asserted-by":"crossref","first-page":"2441","DOI":"10.1007\/s00068-021-01787-w","article-title":"The impact of BMI on morbidity and mortality after femoral fractures","volume":"48","author":"Soliman","year":"2022","journal-title":"Eur J Trauma Emerg Surg"},{"key":"R9-20250614","doi-asserted-by":"crossref","first-page":"e91","DOI":"10.1097\/BOT.0000000000000167","article-title":"Morbid obesity increases the risk for systemic complications in patients with femoral shaft fractures","volume":"29","author":"Weinlein","year":"2015","journal-title":"J Orthop Trauma"},{"key":"R10-20250614","doi-asserted-by":"crossref","first-page":"9","DOI":"10.52312\/jdrs.2023.649","article-title":"Does obesity affect diaphyseal femoral fracture healing treated with intramedullary locking nail?","volume":"34","author":"Issace","year":"2023","journal-title":"Jt Dis Relat Surg"},{"key":"R11-20250614","first-page":"523","article-title":"Results of femoral intramedullary nailing in patients who are obese versus those who are not obese: a prospective multicenter comparison study","volume":"21","author":"Tucker","year":"2007","journal-title":"J Orthop Trauma"},{"issue":"suppl 1","key":"R12-20250614","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/BOT.0000000000001063","article-title":"Fracture and dislocation classification compendium-2018","volume":"32","author":"Meinberg","year":"2018","journal-title":"J Orthop Trauma"},{"key":"R13-20250614","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/jbmr.1998","article-title":"Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research","volume":"29","author":"Shane","year":"2014","journal-title":"J Bone Mineral Res"},{"key":"R14-20250614","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1093\/geront\/9.3_Part_1.179","article-title":"Assessment of older people: self-maintaining and instrumental activities of daily living","volume":"9","author":"Lawton","year":"1969","journal-title":"Gerontologist"},{"key":"R15-20250614","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1001\/jama.1963.03060120024016","article-title":"Studies of illness in the aged. The index of adl: a standardized measure of biological and psychosocial function","volume":"185","author":"Katz","year":"1963","journal-title":"JAMA"},{"key":"R16-20250614","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1302\/2633-1462.210.BJO-2021-0071.R1","article-title":"Sensitivity and specificity of modified RUST score using clinical and radiographic findings as a gold standard","volume":"2","author":"Plumarom","year":"2021","journal-title":"Bone Jt Open"},{"key":"R19-20250614","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/S0020-1383(96)00136-2","article-title":"\u201cThe bigger they come.\u201d: the relationship between body mass index and severity of ankle fractures, \u2019: the relationship between body mass index and severity of ankle fractures","volume":"27","author":"Spaine","year":"1996","journal-title":"Injury"},{"key":"R20-20250614","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s00402-022-04338-z","article-title":"Patient obesity is associated with severity of proximal humerus fractures, not outcomes","volume":"143","author":"Boadi","year":"2023","journal-title":"Arch Orthop Trauma Surg"},{"key":"R21-20250614","doi-asserted-by":"crossref","first-page":"7583204","DOI":"10.1155\/2020\/7583204","article-title":"Does open reduction in intramedullary nailing of femur shaft fractures adversely affect the outcome? A retrospective study","volume":"2020","author":"Ghouri","year":"2020","journal-title":"Adv Orthop"},{"key":"R22-20250614","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1097\/BOT.0000000000000324","article-title":"Obesity is associated with more complications and longer hospital stays after orthopaedic trauma","volume":"29","author":"Childs","year":"2015","journal-title":"J Orthop Trauma"},{"key":"R23-20250614","doi-asserted-by":"crossref","first-page":"21514593221094730","DOI":"10.1177\/21514593221094730","article-title":"Standardized preoperative pathways determining preoperative echocardiogram usage continue to improve hip fracture quality","volume":"13","author":"Esper","year":"2022","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"R24-20250614","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1097\/CORR.0000000000002142","article-title":"No differences between white and non-white patients in terms of care quality metrics, complications, and death after hip fracture surgery when standardized care pathways are used","volume":"481","author":"Parola","year":"2023","journal-title":"Clin Orthop Relat Res"},{"key":"R25-20250614","doi-asserted-by":"crossref","first-page":"73","DOI":"10.21037\/aoj.2018.08.03","article-title":"Is obesity a risk factor for extended length of stay and readmission after total hip arthroplasty?","volume":"3","author":"Richard","year":"2018","journal-title":"Ann Joint"},{"key":"R26-20250614","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1302\/0301-620X.89B6.18356","article-title":"Does obesity influence the outcome after the operative treatment of ankle fractures?","volume":"89","author":"Strauss","year":"2007","journal-title":"J Bone Joint Surg Br"}],"container-title":["Journal of Orthopaedic Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000002813","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T18:01:59Z","timestamp":1749924119000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000002813"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":24,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/bot.0000000000002813","relation":{},"ISSN":["0890-5339"],"issn-type":[{"value":"0890-5339","type":"print"}],"subject":[],"published":{"date-parts":[[2024,7]]},"assertion":[{"value":"2023-10-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}}]}}