Title : A snapshot study on the reasons and outcomes of orthopaedic admissions of extremely obese patients in the Kingdom of Fife
Abstract:
Introduction & Objectives: Scotland has one of the highest obesity rates in the developed world, with 30% of adults classified as obese. Fife has even higher at 32%, making it one of the most affected regions. Extreme obesity (BMI >50) poses significant challenges in orthopaedic care, including increased surgical complications, prolonged hospital stays, and complex post-operative management. This study provides a snapshot of the demographics, reasons for admission, and treatment outcomes of super-obese patients attending an orthopaedic service in Fife.
Study Design & Methods: A prospective study was conducted on all patients with BMI >50 attending the lower limb orthopaedic clinic or admitted acutely under a single surgeon’s care at Victoria Hospital, NHS Fife, between October 2024 and February 2025. Data collected included demographics, working status, admission reasons, treatment modalities, and clinical outcomes.
Results: Eleven patients (8 female, 3 male) were included, with a mean age of 57 years (range: 19–77) and mean BMI of 55 (range: 51–62). Eight (72.7%) were seen in the outpatient clinic, while three (27.3%) were trauma admissions. Six (54.5%) received conservative management, while five (45.5%) required surgery: total knee replacement (2), soft tissue procedures (2), and ankle fracture fixation (1). Weight management advice was given to 10 patients (90.9%). Five (45.5%) lived in the most deprived areas.
Conclusion: Extreme obesity burdens orthopaedic services. Most patients required conservative management, while some surgical. Additional resources and a multidisciplinary approach is essential, and socioeconomic deprivation complicates treatment accessibility, highlighting the need for targeted public health interventions.
