Bone fractures in children: is there an association with obesity?
OBJECTIVE
To determine the relationship between body mass index (BMI) and odds of extremity bone fractures in children.


METHODS
This was a prospective cross-sectional study conducted at 2 tertiary care pediatric emergency departments. A convenience sample of children 2-17 years of age with a nonpenetrating extremity injury was enrolled. Demographics, activity level, mechanism of injury, participant BMI, and presence of a fracture were recorded. The main outcome was the odds of an extremity bone fracture based on BMI category; logistic regression was used to estimate the odds of fracture by BMI category.


RESULTS
We enrolled 2213 children, of whom 1078 (48.7%) sustained a fracture and 316 (14.3%) were classified as obese. The mean (SD) age was 9.5 (4.2) years, and percentage of male children was 56.8%. Compared with children with a normal BMI, the adjusted odds of fracture among obese, overweight, and underweight children were 0.75 (0.58, 0.97), 1.15 (0.89, 1.48), and 1.44 (1.00, 2.07) respectively.


CONCLUSIONS
Obese children had a minor but statistically significant decreased odds of fracture relative to children with a normal BMI, but no association was observed in overweight children. However, underweight children were found to be at an increased odds of fracture. This study suggests that overweight and obese children do not have increased odds of extremity fracture.
Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada. Electronic address: vsabhaney@cw.bc.ca.
Vikram
V
Sabhaney
Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
Kathy
K
Boutis
Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada.
Gaby
G
Yang
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
Lorena
L
Barra
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
Reetika
R
Tripathi
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
Tinh Trung
TT
Tran
Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada.
Quynh
Q
Doan
D000293:Adolescent; D015992:Body Mass Index; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D009043:Motor Activity; D050177:Overweight / Q000453:epidemiology; D063766:Pediatric Obesity / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D013851:Thinness / Q000453:epidemiology