Retrospective case series from two level I trauma centers reviewing closed intramedullary nailing for femoral fractures in 7 morbidly obese patients (BMI ≥37 kg/m²) over 5 years, asking whether this technique is feasible and what specific complications should be anticipated in this population.
When nailing a femoral fracture in a morbidly obese patient, anticipate doubled operative time, >1 L blood loss, and a high trochanteric start-point failure rate — have a low threshold to osteotomize the trochanteric tip and accept a more lateral entry point.
The near-universal thromboembolic risk demands mandatory DVT prophylaxis; if systemic anticoagulation is contraindicated, plan for IVC filter placement.
Retrospective case series from two level I trauma centers reviewing closed intramedullary nailing for femoral fractures in 7 morbidly obese patients (BMI ≥37 kg/m²) over 5 years, asking whether this technique is feasible and what specific complications should be anticipated in this population.
When nailing a femoral fracture in a morbidly obese patient, anticipate doubled operative time, >1 L blood loss, and a high trochanteric start-point failure rate — have a low threshold to osteotomize the trochanteric tip and accept a more lateral entry point.
The near-universal thromboembolic risk demands mandatory DVT prophylaxis; if systemic anticoagulation is contraindicated, plan for IVC filter placement.