Document Detail

Childhood obesity is associated with increased risk of most lower extremity fractures.
MedLine Citation:
PMID:  23054515     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A number of studies have found an increased risk of lower extremity injuries in obese patients. Most studies, however, are unable to provide stable population-based estimates based on the degree of obesity and few assess the risk pertaining to more detailed fracture location in the lower extremities.
QUESTIONS/PURPOSES: We therefore investigated the relationship between obesity and lower extremity fractures in different age and fracture locations in a stable population.
METHODS: This is a population-based, cross-sectional study from the electronic medical records of 913,178 patients aged 2 to 19 years. The body mass index (BMI) for each patient in the cohort was used to stratify patients into five weight classes (underweight, normal weight, overweight, moderate obesity, and extreme obesity) based on BMI for age. Records were assessed for the occurrence of lower extremity fractures for each cohort member. The associations among the five weight classes and specific lower extremity fractures were estimated using multiple logistic regression models and expressed with odds ratios (ORs) and 95% confidence intervals (CIs) using multivariate analysis to adjust for patient demographic variables.
RESULTS: Overweight, moderately obese, and extremely obese patients all had an increased OR of fractures of the foot (OR, 1.14, 1.23, and 1.42, respectively, with 95% CI, 1.04-1.24, 1.12-1.35, and 1.26-1.61, respectively) along with the ankle, knee, and leg (OR, 1.27, 1.28, and 1.51, respectively, with 95% CI, 1.16-1.39, 1.15-1.42, and 1.33-1.72, respectively). The association was strongest in the 6- to 11-year-old age group. We found no association between increasing BMI and increased risk of fractures of the femur and hip.
CONCLUSIONS: Increasing BMI is associated with increased odds of foot, ankle, leg, and knee fractures in children.
LEVEL OF EVIDENCE: Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Jeff Kessler; Corinna Koebnick; Ning Smith; Annette Adams
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  471     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-04     Completed Date:  2013-05-16     Revised Date:  2014-04-01    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1199-207     Citation Subset:  AIM; IM    
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MeSH Terms
Body Mass Index
California / epidemiology
Child, Preschool
Cross-Sectional Studies
Fractures, Bone / epidemiology,  etiology*,  physiopathology*
Logistic Models
Lower Extremity*
Obesity / complications*,  epidemiology,  physiopathology*
Risk Factors
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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