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OBJECTIVE To determine the effect of obesity on rates of systemic complication in operatively treated acetabular fractures. DESIGN Retrospective Case Control study. SETTING Level 1 Trauma CenterPatients/Participants: All patients with acetabular fractures managed operatively from January 2015-December 2019. Patients were divided into groups based on their Body Mass Index (Normal weight=BMI 40). INTERVENTION Operative management of an acetabular fracture. MAIN OUTCOME MEASUREMENT Systemic complications including mortality, sepsis, pneumonia, acute respiratory distress syndrome, deep vein thrombosis, pulmonary embolism, or venous thrombotic event. RESULTS A total of 428 patients were identified. 109 (25.4%) were normal weight, 133(31.1%) were overweight, 133(31.1%) were obese, and 53(12.4%) were morbidly obese. The rate of systemic complications was 17.5% and overall mortality rate was 0.005%. There were no significant differences between the different BMI groups in all-cause complication or any individual complication. When the morbidly obese group was compared to all other patients, there were also no significant differences in all-cause complication or any individual complications. CONCLUSION In conclusion, in this study there was no association with increasing BMI and inpatient systemic complications after operative management of acetabular fractures. As we continue to refine our understanding of how obesity affects outcomes after acetabular fracture surgery, other indices of obesity might prove more useful in predicting complications. In the obese population, there are well-documented risks of postoperative infections and challenges in obtaining an anatomic reduction, but the fear of postoperative systemic complications should not deter surgeons from undertaking operative management of acetabular fractures in the obese population. As the prevalence of obesity in trauma patients continues to increase, it is incumbent upon us to continue to improve our understanding of optimal treatment for our patients. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Background: This study investigated the outcomes of coronavirus disease (COVID-19)-positive patients undergoing hip fracture surgery using a national database. Methods: This is a retrospective cohort study comparing hip fracture surgery outcomes between COVID-19 positive and negative matched cohorts from 46 sites in the United States. Patients aged 65 and older with hip fracture surgery between March 15 and December 31, 2020, were included. The main outcomes were 30-day all-cause mortality and all-cause mortality. Results: In this national study that included 3303 adults with hip fracture surgery, the 30-day mortality was 14.6% with COVID-19-positive versus 3.8% in COVID-19-negative, a notable difference. The all-cause mortality for hip fracture surgery was 27.0% in the COVID-19-positive group during the study period. Dicussion: We found higher incidence of all-cause mortality in patients with versus without diagnosis of COVID-19 after undergoing hip fracture surgery. The mortality in hip fracture surgery in this national analysis was lower than other local and regional reports. The medical community can use this information to guide the management of hip fracture patients with a diagnosis of COVID-19.