Obesity Increases Complexity of Distal Radius Fracture in Fall From Standing Height

To investigate the relationship between obesity and distal radius fracture severity after low-energy trauma and to identify patient-specific risk factors predictive of increasing fracture severity.

Retrospective review.

Level 1 Trauma Center.

Four hundred twenty-three adult subjects with a history of fracture of the distal radius resulting from a fall from standing height.

Demographic data and injury characteristics were obtained. Preoperative wrist radiographs were reviewed and classified by the OTA classification system. Distal radius fractures were categorized as simple [closed and extra-articular (OTA 23-A)] and complex [intra-articular (OTA 23-B or 23-C) or open fracture or concomitant ipsilateral upper extremity fracture]. Multivariate logistic regression was completed to model the probability of incurring a complex fracture.

Simple versus complex fracture pattern.

Average age at the time of injury was 53.8 years (range, 18.9-98.4). Seventy-nine percent of subjects were female. The average body-mass index was 28.1 (range, 13.6-59.5). Two hundred forty-four patients (58%) suffered complex distal radius fractures per study criteria. Obese patients (body-mass index > 30) demonstrated increased fracture severity as per the OTA classification (P = 0.039) and were more likely to suffer a complex injury (P = 0.032). Multivariate regression identified male gender, obesity, and age ≥50 as independent risk factors for sustaining a complex fracture pattern.

Obesity is associated with more complex fractures of the distal radius after low-energy trauma, particularly in elderly patients. This relationship may have important epidemiologic implications predictive of future societal fracture burden and severity in an obese, aging population.

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.