The Influence of BMI and Other Measures of Adiposity on Risks and Outcomes in Orthopaedic Traumatology

Obesity significantly influences risks and outcomes in orthopaedic trauma surgery, presenting unique challenges across various fracture types. This comprehensive review synthesizes current evidence on the impact of elevated body mass index (BMI) on orthopaedic trauma, highlighting epidemiological trends, perioperative considerations, surgical challenges, and postoperative complications. High BMI correlates with substantially higher intra- and post-operative risks, such as infection, nonunion, and thromboembolic events. Central adiposity further compounds fracture risks and complicates surgical management beyond BMI alone. Despite these challenges, tailored perioperative planning, vigilant postoperative management, and technical surgical adaptations can mitigate some obesity-associated risks. Future research should identify specific BMI or adiposity thresholds associated with increased risk and determine the optimal surgical techniques or interventions to improve outcomes in this growing patient population.