Childhood obesity as a risk factor for lateral condyle fractures over supracondylar humerus fractures pediatrics

Eric D. Fornari, Mike Suszter, Joanna Roocroft, Tracey Bastrom, Eric W. Edmonds, John Schlechter

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Obese children reportedly have an increased risk of sustaining musculoskeletal injuries compared with their normal-weight peers. Obese children are at greater risk for sustaining fractures of the forearm, particularly from low-energy mechanisms. Furthermore, obesity is a risk factor for sustaining an extremity fracture requiring surgery. However, it is unclear what role obesity plays in fractures about the distal humerus. Questions/purposes: We therefore asked whether (1) children who sustain lateral condyle (LC) fractures have a higher body mass index (BMI) as compared with those with supracondylar (SC) humerus fractures; and (2) children with a higher BMI sustain more severe fractures regardless of fracture pattern. Methods: We retrospectively reviewed 992 patients: 230 with LC injuries and 762 with SC fractures. We determined BMI and BMI-for-age percentiles. Fracture types were classified by the systems proposed by Weiss et al. (LC fractures) and Wilkins (SC fractures). Results: The LC group had both a higher mean BMI and BMI-for-age percentile than the SC group as well as had more obese patients (37% versus 19%). Within the LC group, children with Type 3 fractures had a higher BMI that those with Type 1 fractures (19 versus 17). There was a higher percentage of obese patients with Type 3 LC fractures compared with Type 1 and 2 fractures (44% versus 27% and 26%). Among patients with SC fractures, there was no difference among the BMI, BMI-for-age percentiles, or percentage of obese children when analyzed by fracture subtype. Conclusions: Obesity places a child at greater risk for sustaining a LC fracture and when these fractures occur, they are often more severe injuries compared with those in nonobese children. Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)1193-1198
Number of pages6
JournalClinical Orthopaedics and Related Research
Volume471
Issue number4
DOIs
StatePublished - Apr 2013
Externally publishedYes

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Pediatric Obesity
Humerus
Body Mass Index
Pediatrics
Bone and Bones
Obesity
Wounds and Injuries
Forearm
Extremities
Guidelines
Weights and Measures

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Childhood obesity as a risk factor for lateral condyle fractures over supracondylar humerus fractures pediatrics. / Fornari, Eric D.; Suszter, Mike; Roocroft, Joanna; Bastrom, Tracey; Edmonds, Eric W.; Schlechter, John.

In: Clinical Orthopaedics and Related Research, Vol. 471, No. 4, 04.2013, p. 1193-1198.

Research output: Contribution to journalArticle

Fornari, Eric D. ; Suszter, Mike ; Roocroft, Joanna ; Bastrom, Tracey ; Edmonds, Eric W. ; Schlechter, John. / Childhood obesity as a risk factor for lateral condyle fractures over supracondylar humerus fractures pediatrics. In: Clinical Orthopaedics and Related Research. 2013 ; Vol. 471, No. 4. pp. 1193-1198.
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abstract = "Background: Obese children reportedly have an increased risk of sustaining musculoskeletal injuries compared with their normal-weight peers. Obese children are at greater risk for sustaining fractures of the forearm, particularly from low-energy mechanisms. Furthermore, obesity is a risk factor for sustaining an extremity fracture requiring surgery. However, it is unclear what role obesity plays in fractures about the distal humerus. Questions/purposes: We therefore asked whether (1) children who sustain lateral condyle (LC) fractures have a higher body mass index (BMI) as compared with those with supracondylar (SC) humerus fractures; and (2) children with a higher BMI sustain more severe fractures regardless of fracture pattern. Methods: We retrospectively reviewed 992 patients: 230 with LC injuries and 762 with SC fractures. We determined BMI and BMI-for-age percentiles. Fracture types were classified by the systems proposed by Weiss et al. (LC fractures) and Wilkins (SC fractures). Results: The LC group had both a higher mean BMI and BMI-for-age percentile than the SC group as well as had more obese patients (37{\%} versus 19{\%}). Within the LC group, children with Type 3 fractures had a higher BMI that those with Type 1 fractures (19 versus 17). There was a higher percentage of obese patients with Type 3 LC fractures compared with Type 1 and 2 fractures (44{\%} versus 27{\%} and 26{\%}). Among patients with SC fractures, there was no difference among the BMI, BMI-for-age percentiles, or percentage of obese children when analyzed by fracture subtype. Conclusions: Obesity places a child at greater risk for sustaining a LC fracture and when these fractures occur, they are often more severe injuries compared with those in nonobese children. Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.",
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AB - Background: Obese children reportedly have an increased risk of sustaining musculoskeletal injuries compared with their normal-weight peers. Obese children are at greater risk for sustaining fractures of the forearm, particularly from low-energy mechanisms. Furthermore, obesity is a risk factor for sustaining an extremity fracture requiring surgery. However, it is unclear what role obesity plays in fractures about the distal humerus. Questions/purposes: We therefore asked whether (1) children who sustain lateral condyle (LC) fractures have a higher body mass index (BMI) as compared with those with supracondylar (SC) humerus fractures; and (2) children with a higher BMI sustain more severe fractures regardless of fracture pattern. Methods: We retrospectively reviewed 992 patients: 230 with LC injuries and 762 with SC fractures. We determined BMI and BMI-for-age percentiles. Fracture types were classified by the systems proposed by Weiss et al. (LC fractures) and Wilkins (SC fractures). Results: The LC group had both a higher mean BMI and BMI-for-age percentile than the SC group as well as had more obese patients (37% versus 19%). Within the LC group, children with Type 3 fractures had a higher BMI that those with Type 1 fractures (19 versus 17). There was a higher percentage of obese patients with Type 3 LC fractures compared with Type 1 and 2 fractures (44% versus 27% and 26%). Among patients with SC fractures, there was no difference among the BMI, BMI-for-age percentiles, or percentage of obese children when analyzed by fracture subtype. Conclusions: Obesity places a child at greater risk for sustaining a LC fracture and when these fractures occur, they are often more severe injuries compared with those in nonobese children. Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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