Obesity, smoking do not impact long-term healing of wrist fractures
(HealthDay)—Excellent clinical and radiographic outcomes can be achieved with surgery for displaced wrist fractures in patients who are obese and in those who smoke, according to a study published in the December issue of the Journal of Hand Surgery.
Matthew J. Hall, M.D., from Beth Israel Deaconess Medical Center in Boston, and colleagues compared functional and radiographic outcomes among patients with and without obesity and by smoking status. All patients were surgically treated for a distal radius fracture between 2006 and 2017 at two level 1 trauma centers. Analysis included 200 patients (39 with body mass index [BMI] ≥30 kg/m² and 161 with BMI <30 kg/m²; 148 never smokers, 32 former smokers, and 20 current smokers).
The researchers found that while obese patients had more comorbidities, fracture types were similar between the BMI groups. Acceptable Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores were achieved by both BMI groups at three-month and one-year follow-up. Additionally, the two groups were similar regarding motion, Radiographic Union Scoring System score, and alignment. Smokers had higher QuickDASH scores and a lower percentage of radiographically healed fractures (40 percent versus 69 to 82 percent) at three months. At final follow-up, differences in QuickDASH were small and range of motion, fracture healing, and complication rates were similar between the three smoking groups.
"Our results show that treatment for distal radius fractures in obese and smoking patients is safe, and these patients may be treated like the general population with similar long-term results," a coauthor said in a statement.
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