Scholarlink

Purpose <p>The influence of body mass index (BMI) on fracture healing after femoral shaft intramedullary nailing remains unclear, particularly regarding postoperative weight-bearing decisions. This study evaluated whether elevated BMI was associated with delayed union after intramedullary nailing of adult femoral shaft fractures and whether weight-bearing protocol modified this association.</p> Methods <p>This retrospective cohort study included adults with AO/OTA 32 femoral shaft fractures treated with intramedullary nailing at a Level I trauma center between November 2021 and April 2025. Patients with more than 6&#xa0;months of clinical and radiographic follow-up were included. The primary exposure was BMI ≥ 25&#xa0;kg/m<sup>2</sup>. The primary outcome was delayed union beyond 24&#xa0;weeks. Multivariable logistic regression adjusted for age, sex, smoking, diabetes mellitus, AO/OTA 32C fracture, and open fracture.</p> Results <p>The final cohort included 174 patients: 53 with BMI &lt; 25&#xa0;kg/m<sup>2</sup> and 121 with BMI ≥ 25&#xa0;kg/m<sup>2</sup>. Delayed union occurred in 30.6% of patients with BMI ≥ 25&#xa0;kg/m<sup>2</sup> and 13.2% of patients with BMI &lt; 25&#xa0;kg/m<sup>2</sup>, <i>p</i> = 0.015. BMI ≥ 25&#xa0;kg/m<sup>2</sup> remained independently associated with delayed union, adjusted OR 3.14, 95% CI 1.24 to 7.91. BMI ≥ 30&#xa0;kg/m<sup>2</sup> and continuous BMI were not independently associated with delayed union. Immediate weight bearing was not independently associated with delayed union, and no significant BMI by weight-bearing interaction was observed.</p> Conclusion <p>BMI ≥ 25&#xa0;kg/m<sup>2</sup> was associated with delayed union, but this was not reproduced with obesity-based or continuous definitions. Elevated BMI alone should not mandate weight-bearing restriction.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Body mass index, weight bearing, and delayed union after femoral shaft fracture nailing: a retrospective cohort study

  • 期刊论文

  • 发表日期：

    2026年8月1日

查看全文
  • Ilan Tzaytlin,
  • Artsiom Abialevich,
  • Vladislav Osinsky,
  • Yotam Heinemann,
  • Vadim Benkovich,
  • Asaf Acker

摘要

Purpose

The influence of body mass index (BMI) on fracture healing after femoral shaft intramedullary nailing remains unclear, particularly regarding postoperative weight-bearing decisions. This study evaluated whether elevated BMI was associated with delayed union after intramedullary nailing of adult femoral shaft fractures and whether weight-bearing protocol modified this association.

Methods

This retrospective cohort study included adults with AO/OTA 32 femoral shaft fractures treated with intramedullary nailing at a Level I trauma center between November 2021 and April 2025. Patients with more than 6 months of clinical and radiographic follow-up were included. The primary exposure was BMI ≥ 25 kg/m2. The primary outcome was delayed union beyond 24 weeks. Multivariable logistic regression adjusted for age, sex, smoking, diabetes mellitus, AO/OTA 32C fracture, and open fracture.

Results

The final cohort included 174 patients: 53 with BMI < 25 kg/m2 and 121 with BMI ≥ 25 kg/m2. Delayed union occurred in 30.6% of patients with BMI ≥ 25 kg/m2 and 13.2% of patients with BMI < 25 kg/m2, p = 0.015. BMI ≥ 25 kg/m2 remained independently associated with delayed union, adjusted OR 3.14, 95% CI 1.24 to 7.91. BMI ≥ 30 kg/m2 and continuous BMI were not independently associated with delayed union. Immediate weight bearing was not independently associated with delayed union, and no significant BMI by weight-bearing interaction was observed.

Conclusion

BMI ≥ 25 kg/m2 was associated with delayed union, but this was not reproduced with obesity-based or continuous definitions. Elevated BMI alone should not mandate weight-bearing restriction.