Obesity and Failure of Nonsurgical Management of Pediatric Both-Bone Forearm Fractures
Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved..
PURPOSE: In pediatric extremity fractures treated nonsurgically, maintaining reduction can be difficult in obese children owing to the larger soft tissue envelope. The purpose of this study was to investigate the relationship between obesity and failure of nonsurgical management of pediatric both-bone forearm fractures.
METHODS: We conducted a retrospective review of 129 skeletally immature patients older than 2 years who received nonsurgical treatment for closed radius and ulna shaft fractures at a level I pediatric trauma center between 2011 and 2014. The patients were divided into 2 groups: (1) normal-weight children and (2) overweight and obese children. The primary outcome measure was failure of nonsurgical management, defined as the indication for repeat closed reduction under anesthesia or surgical intervention owing to unacceptable angulation after initial closed treatment.
RESULTS: Of the 129 patients included in the study, 34 patients (26%) were female and 95 patients (74%) were male. Seventy-six patients (59%) were normal weight, 27 patients (22%) were obese, and 26 patients (20%) were overweight. Eighteen percent (14 of 76) of normal-weight children failed nonsurgical management compared with 34% (18 of 53) of overweight and obese children. Twenty-nine percent (4 of 14) of normal-weight children who failed nonsurgical management required surgery compared with 56% (10 of 18) of overweight and obese children.
CONCLUSIONS: Overweight and obese children have a significantly higher rate of failure of nonsurgical management of both-bone forearm fractures compared with normal-weight children. These patients may benefit from closer clinical follow-up and a lower threshold for surgical intervention.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognosis II.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
The Journal of hand surgery - 42(2017), 9 vom: 01. Sept., Seite 711-716 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Okoroafor, Ugochi C [VerfasserIn] |
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| Links: |
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| Themen: |
Forearm fracture |
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| Anmerkungen: |
Date Completed 13.06.2018 Date Revised 13.06.2018 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jhsa.2017.06.006 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM274080281 |
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| 500 | |a Date Completed 13.06.2018 | ||
| 500 | |a Date Revised 13.06.2018 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: In pediatric extremity fractures treated nonsurgically, maintaining reduction can be difficult in obese children owing to the larger soft tissue envelope. The purpose of this study was to investigate the relationship between obesity and failure of nonsurgical management of pediatric both-bone forearm fractures | ||
| 520 | |a METHODS: We conducted a retrospective review of 129 skeletally immature patients older than 2 years who received nonsurgical treatment for closed radius and ulna shaft fractures at a level I pediatric trauma center between 2011 and 2014. The patients were divided into 2 groups: (1) normal-weight children and (2) overweight and obese children. The primary outcome measure was failure of nonsurgical management, defined as the indication for repeat closed reduction under anesthesia or surgical intervention owing to unacceptable angulation after initial closed treatment | ||
| 520 | |a RESULTS: Of the 129 patients included in the study, 34 patients (26%) were female and 95 patients (74%) were male. Seventy-six patients (59%) were normal weight, 27 patients (22%) were obese, and 26 patients (20%) were overweight. Eighteen percent (14 of 76) of normal-weight children failed nonsurgical management compared with 34% (18 of 53) of overweight and obese children. Twenty-nine percent (4 of 14) of normal-weight children who failed nonsurgical management required surgery compared with 56% (10 of 18) of overweight and obese children | ||
| 520 | |a CONCLUSIONS: Overweight and obese children have a significantly higher rate of failure of nonsurgical management of both-bone forearm fractures compared with normal-weight children. These patients may benefit from closer clinical follow-up and a lower threshold for surgical intervention | ||
| 520 | |a TYPE OF STUDY/LEVEL OF EVIDENCE: Prognosis II | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a forearm fracture | |
| 650 | 4 | |a obesity | |
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| 700 | 1 | |a McGinty, Jasmin L |e verfasserin |4 aut | |
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