Obesity Ups Ankle Fracture Severity

Lose weight and save your ankles. According to Lynda Williams, writing July 13 in News Medical, obese patients experience more severe ankle fractures than do individuals with a healthy body mass index (BMI). Her report focused on study findings, published in the Journal of Foot and Ankle Surgery, which reported that patients with a BMI of 30 kg/m2 or above were almost twice as likely to have a Weber C fracture as they were to experience the less critical type A or B fractures.

Patients with Weber C fractures are routinely recommended for surgery and their fracture usually disrupts the tibiofibular syndesmosis, causing instability, explained Christy King of the Kaiser San Francisco Bay Area Foot and Ankle Residency Program. Patients who experience a Weber A fracture do not require surgery unless there is a medial injury, and patients with type B fractures are operated on only if there are also complex bimalleolar, trimalleolar, or bimalleolar equivalent fractures.

In their study, the researchers reviewed radiographs from 280 patients, 180 of whom were female. The women had an average age of 52 years. Half (51.4%) the patients had a BMI of 30 kg/m2. Of these, 21% had Weber A fractures, 59% had B fractures, and 20% had C fractures. Obese patients accounted for 46% of Weber A, 50% of Weber B fractures, and 61% of Weber C fractures.

In multivariate analysis, the odds ratio for Weber C versus A and B fractures was 1.78 for obese patients. The likelihood of Weber C fractures was not influenced, however, by patients’ osteoporosis, tobacco use, or bone mineral density. The researchers did note that overweight or obese patients generally experience a more complicated recovery than do those with a healthy weight. They believe that it is important that patients be aware of the potential risks of obesity, including the possibility of experiencing a more severe ankle fracture.