Previous Next

ARCHIVE

№2' 2021

SURGERY

International Medical Journal, Vol. 27., Iss. 2, 2021, P. 43−46.

DOI (https://doi.org/10.37436/2308-5274-2021-2-7)

PROBLEM OF OVERWEIGHT IN TREATMENT OF PATIENTS WITH TIBIAL FRACTURES

Kharkiv National Medical University, Ukraine

Recently, the prevalence of overweight and obesity among the world's population has become a pandemic. According to many authors, this is facilitated by rapid electrification and gadgetization, the transition to a free labor market, increasing the impact of stressful situations, rising the number of vehicles and fast food restaurants, changing food culture and general physical activity, quarantine restrictions through COVID−19. Individuals with a higher body mass index have been found to have a significant risk of fractures in segments such as the humerus, tibia, and calcaneus. This may be due to the increased risk of falling and their different structure compared to non−obese individuals. It is known that overweight and obese patients need an individualized approach to their treatment, due to the difficulties that arise in the process of providing medical care. Excess body weight causes difficulties in transporting the patient to the hospital, its preoperative preparation, stabilization of the general condition and local condition of parafractory soft tissues, limits the choice of anesthesia for the patient. The results of treatment of 773 people were analyzed and evaluated, among which 442 had isolated fractures of the tibia. It is concluded that the classical approach to treatment of such patients is not perfect, because sustainable approaches to treatment tactics can not fully ensure quality of life, restoration of body functions in general and the lower extremity in particular, the return of a person to active life. Neglecting the lifestyle, peculiarities of food and motor diets, overweight, psycho−emotional features on the background of a tibial fracture lead to the choice of suboptimal rehabilitation program for such patients.

Key words: overweight, obesity, tibial fractures, complications.

REFERENCES

1. Nagorna І. S. Ozhirіnnya yak sotsіal'na problema suchasnoї molodі // Suchasne ukraїns'ke studentstvo: problemi ta tsіnnіsnі orієntatsії: materіali V Vseukraїns'koї nauk.−prakt. konf. studentіv ta molodikh vchenikh. Khmel'nits'kii: KhІST; 2011. S. 182−185.

2. Ermolenko N. A., Zarudna O. I. Ozhirіnnya − problema suchasnostі // Medsestrinstvo. 2017. № 1. doi: https://doi.org/10.11603/2411−1597.2016.1.7385

3. Bill L. Kak sbrosit' lishnii ves. M.: AST; Astrel', 2005. 314 s.

4. Grigoruk V. V. Lіkuval'na taktika pri sumіzhnikh ta kontrlateral'nikh perelomakh kіstok nizhnіkh kіntsіvok: dis. kand. med. nauk: 14.01.21, NAMN Ukraїni, DU "Іnstitut patologії khrebta ta suglobіv іm. M. І. Sitenka NAMN Ukraїni". Kh., 2013. 200 s.

5. Іvashchenko L. Ya., Goncharenko L. І. Fіzichna pіdgotovka profіlaktiko−ozdorovchoї spryamovanostі dlya vіis'kovosluzhbovtsіv z nedostatnіm rіvnem fіzichnoї pіdgotovlenostі і rizikom rozvitku sertsevo−sudinnikh zakhvoryuvan': navch.−metod. posіb. K.: 2011. 133 s

6. Vsesvіtnya organіzatsіya okhoroni zdorov'ya. Pitannya travmatizmu. URL: https://www.who.int/surgery/challenges/esc_injuries/ru/

7. Premaor M. O., Comim F. V., Compston J. E. Obesity and fractures. Arq. Bras. Endocrinol. Metabol. 2014. № 58 (5). R. 470−477. doi: 10.1590/0004−2730000003274

8. Chastota uskladnen' pri lіkuvannі dіafіzarnikh perelomіv kіntsіvok za danimi kharkіvs'koї travmatologіchnoї MSEK: zb. nauk. pr. XVIII z'їzdu ortopedіv−travmatologіv Ukraїni / O. K. Popsuishapka, V. O. Litvishko, O. E. Uzhegova, O. O. Pіdgais'ka. Kh., 2019. S. 53−54.

9. Does morbid obesity negatively affect the hospital course of patients undergoing treatment of closed, lower−extremity diaphyseal long−bone fractures? / D. Keith et al. // Orthopedics. 2011. № 3; 34 (1). R. 18. doi: 10.3928/01477447−20101123−03

10. Pilipchuk V. V., Avgustinovich M. B., Kurіnov O. Yu. Nadlishkova masa tіla yak problema metabolіzmu і fіzichnoї aktivnostі // Pedagogіka, psikhologіya ta mediko−bіologіchnі problemi fіzichnogo vikhovannya і sportu. 2011. № 4. S. 122−124.

11. Fracture risk after bariatric surgery: a 12−year nationwide cohort study / L. Chia−Wen et al. // Medicine. 2015. doi: 10.1097