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Home/Large Joints and Extremities/Fat Kids Are Not Healthy Kids
Large Joints and Extremities

Fat Kids Are Not Healthy Kids

February 25, 2014 1 min read Premium comments

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Fat Kids Are Not Healthy Kids
Source: Wikimedia Commons and Juan Carreno de Miranda
Secondary

Fat kids are not healthy kids. A new study indicates that childhood obesity may be putting children’s musculoskeletal systems at risk. According to new research reported in the February issue of the Journal of Bone and Joint Surgery , obese children who sustain a supracondylar humeral (above the elbow) fracture can be expected to have more complex fractures and experience more postoperative complications than will children of a normal weight.

This is the first study to assess the implications of obesity on this type of a fracture. The investigators, led by Michelle S. Caird, M.D., assistant professor in the department of orthopedic surgery at the University of Michigan, examined the records of 350 patients, ranging in age from 2 to 11 years old. All had undergone operative treatment for supracondylar humeral fractures.

Of the 350 children in the study, 41 were underweight (BMI <5th percentile), 182 were normal weight (BMI in the 5th to 85th percentile), 63 were overweight (BMI in the >85th percentile), and 68 were obese (BMI in the >95th percentile). The study included 149 patients with type-2 fractures (a break through part of the bone at the growth plate and crack through the bone shaft). Researchers diagnosed 11 of these patients with obesity. Of the 205 children with type-3 fractures, they diagnosed 57 with obesity. Using logistic regression, they were able to associate obesity with complex fractures and more complications.

Caird noted that, “these findings show that children diagnosed with obesity are more likely to sustain these complex fractures.” Pediatric obesity is currently an epidemic, with the prevalence having quadruped over the last 25 years, she said, “Our research aims to remind parents that there are many serious risks to childhood obesity, including fractures and surgical complications. It’s important to ensure that children get the proper amount of exercise and to build their bone banks early in life to a strong and healthy frame.”

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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