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Influence of Obesity in Children with Supracondylar Humeral Fractures Requiring Surgical Treatment at a Tertiary
Marko Bašković1,2,3, Lucija Vucković1,4, Marta Borić Krakar1
1Department of Pediatric Surgery, Children's Hospital Zagreb, Ulica Vjekoslava Klaića 16, 10 000 Zagreb, Croatia.
Insights
Childhood obesity is linked to more severe supracondylar humerus fractures in children. Overweight and obese children had a higher proportion of Gartland type III injuries, emphasizing the need to address childhood obesity.
Area of Science:
- Pediatric Orthopedics
- Public Health
- Trauma Surgery
Background:
- Childhood obesity is a growing global health concern with significant implications.
- Supracondylar humerus fractures are common pediatric injuries.
- The relationship between childhood obesity and fracture severity requires further investigation.
Purpose of the Study:
- To investigate the impact of obesity on the severity of supracondylar humerus fractures in children.
- To determine if obesity influences fracture severity in both low- and high-energy trauma scenarios.
Main Methods:
- Retrospective review of electronic medical records for pediatric supracondylar humerus fractures.
- Data collected over a ten-year period (January 1, 2013, to January 1, 2023).
- Analysis of patient demographics, injury characteristics, and obesity-related parameters.
Main Results:
- 618 children with supracondylar humerus fractures were analyzed.
- A significant association was found between body mass index (BMI)-for-age percentile and fracture severity (Gartland classification).
- Overweight and obese children showed a higher proportion of Gartland type III fractures, indicating increased severity.
Conclusions:
- Higher prevalence of overweight and obese children among those with Gartland type III supracondylar humerus fractures.
- Childhood obesity may exacerbate the severity of these fractures.
- Societal efforts to curb childhood obesity are crucial for preventing severe pediatric trauma outcomes.
Background:
Almost everywhere in the world, childhood obesity is becoming a serious public health problem with negative effects on both children's health and society as a whole. The main objective of this study was to determine whether obesity has an effect on the severity of supracondylar humerus fracture in children, regardless of whether it is a low- or high-energy trauma.
Methods:
The electronic records of patients treated for the supracondylar fracture of the humerus in the ten-year period from 1 January 2013 to 1 January 2023 were reviewed retrospectively.
Results:
In the observed period, 618 children, including 365 (59.06%) boys and 253 (40.94%) girls, were hospitalized and treated surgically with the diagnosis of supracondylar fracture. The distributions according to the observed parameters were as follows: age (months) = 88.18 ± 32.64; height (cm) = 123.42 ± 16.83; weight (kg) = 27.18 ± 11.32; body mass index = 17.18 ± 3.06; body mass index-for-age percentile = 57.34 ± 32.11. Overall, 141 (22.82%) fractures were classified as Gartland II, while 477 (77.18%) were classified as Gartland III. A total of 66 (10.68%) fractures were flexion type, while 552 (89.32%) were extension type. The left elbow was affected in 401 (64.89%) children, while the right was affected in 217 (35.11%) children. The main mechanism of injury was a fall at ground level (33.33%). In relation to gender, a statistically significant difference was recorded in body mass index and percentile (p < 0.05). According to Gartland, the proportion of children below and above the 85th percentile in relation to the type of injury was statistically significant (p < 0.05). It was determined that the energy level does not significantly influence the injury's severity: p(GII) = 0.225; p(GIII) = 0.180.
Conclusions:
In our study, we found that the proportion of overweight and obese children requiring surgical treatment was higher in Gartland type III injury, so there is no doubt that as a society we must prevent further increases in the prevalence of childhood obesity for this reason as well.
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