Does obesity affect fracture healing in children? 2013

Rushyuan J Lee, and Nigel N Hsu, and Colleen M Lenz, and Arabella I Leet
Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.

BACKGROUND Obesity is a risk factor for various orthopaedic diseases, including fractures. Obesity's influence on circulating hormones and cytokines and bone mineralization ultimately influences the body's osteogenic response and bone mineralization, potentially increasing the risk of fracture and impacting fracture healing. OBJECTIVE Does obesity delay fracture recovery in overweight or obese children as measured by the time to release to normal activity? Is this average time for return to activity influenced by the mechanism of the injury? Does obesity's effect on mineralization and loading in overweight or obese children lead to a greater proportion of upper extremity fracture versus lower extremity fracture? METHODS We prospectively followed 273 patients with nonpathologic long bone fractures treated from January 2010 to October 2011. Patients were stratified into obese/overweight, normal weight, and underweight groups. All patients were followed until release to regular activities (mean, 41 days; range, 13-100 days). RESULTS Release to regular activities occurred sooner in obese/overweight than in normal weight patients: 39 and 42 days, respectively. A greater proportion of obese/overweight patients had low to moderate energy mechanisms of injury than did normal weight patients, but we found no difference between the groups in terms of return to activity when stratified by mechanism. There was also no difference in the proportion of upper extremity injuries between the two groups. CONCLUSIONS Obese/overweight children did not have a delay in release to activities compared with children of normal weight. METHODS Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D009765 Obesity A status with BODY WEIGHT that is grossly above the recommended standards, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY).
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor

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