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Childhood Obesity as a Risk Factor for Lateral Condyle Fractures Over Supracondylar Humerus Fractures

  • Symposium: Childhood Obesity and Musculoskeletal Problems
  • Published:
Clinical Orthopaedics and Related Research®

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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Fig. 1
Fig. 2A–B

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Acknowledgments

We thank Eli Adhoot for his help with data collection and J. D. Bomar for his assistance in producing the illustrations.

Author information

Authors and Affiliations

  1. Department of Pediatric Orthopedics, Rady Children’s Hospital and Health Center, San Diego, CA, USA

    Eric D. Fornari MD, Joanna Roocroft MA, Tracey Bastrom MA & Eric W. Edmonds MD

  2. Department of Orthopedic Surgery, Children’s Hospital of Orange County, Orange, CA, USA

    Mike Suszter DO & John Schlechter DO

  3. Department of Orthopedic Surgery, Riverside County Regional Medical Center, Moreno Valley, CA, USA

    Mike Suszter DO & John Schlechter DO

  4. 3030 Children’s Way, Suite 410, San Diego, CA, 92123, USA

    Eric D. Fornari MD

Authors
  1. Eric D. Fornari MD
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  2. Mike Suszter DO
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  3. Joanna Roocroft MA
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  4. Tracey Bastrom MA
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  5. Eric W. Edmonds MD
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  6. John Schlechter DO
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Corresponding author

Correspondence to Eric D. Fornari MD.

Additional information

Each author certifies that he or she, or a member of their immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

This study was performed at Rady Children’s Hospital and Health Center, San Diego, CA, USA; Children’s Hospital of Orange County, Orange, CA, USA; and Riverside County Regional Medical Center, Moreno Valley, CA, USA.

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Fornari, E.D., Suszter, M., Roocroft, J. et al. Childhood Obesity as a Risk Factor for Lateral Condyle Fractures Over Supracondylar Humerus Fractures. Clin Orthop Relat Res 471, 1193–1198 (2013). https://doi.org/10.1007/s11999-012-2566-2

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  • DOI: https://doi.org/10.1007/s11999-012-2566-2

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