Does obesity affect fracture healing in children?
BACKGROUND
Obesity is a risk factor for various orthopaedic diseases, including fractures. Obesity's influence on circulating hormones and cytokines and bone mineralization ultimately influences the body's osteogenic response and bone mineralization, potentially increasing the risk of fracture and impacting fracture healing.


OBJECTIVE
Does obesity delay fracture recovery in overweight or obese children as measured by the time to release to normal activity? Is this average time for return to activity influenced by the mechanism of the injury? Does obesity's effect on mineralization and loading in overweight or obese children lead to a greater proportion of upper extremity fracture versus lower extremity fracture?


METHODS
We prospectively followed 273 patients with nonpathologic long bone fractures treated from January 2010 to October 2011. Patients were stratified into obese/overweight, normal weight, and underweight groups. All patients were followed until release to regular activities (mean, 41 days; range, 13-100 days).


RESULTS
Release to regular activities occurred sooner in obese/overweight than in normal weight patients: 39 and 42 days, respectively. A greater proportion of obese/overweight patients had low to moderate energy mechanisms of injury than did normal weight patients, but we found no difference between the groups in terms of return to activity when stratified by mechanism. There was also no difference in the proportion of upper extremity injuries between the two groups.


CONCLUSIONS
Obese/overweight children did not have a delay in release to activities compared with children of normal weight.


METHODS
Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Rushyuan J
RJ
Lee
Nigel N
NN
Hsu
Colleen M
CM
Lenz
Arabella I
AI
Leet
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D017102:Fracture Healing / Q000502:physiology*; D050723:Fractures, Bone / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D009765:Obesity / Q000150:complications* / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors