title: The Association Between Weight Status and Pediatric Forearm Fractures Resulting From Ground-Level Falls.
abstract: OBJECTIVE
  The purpose of our study was to evaluate the hypothesis that pediatric forearm fractures resulting from ground-level falls are associated with increased weight status (weight for age/sex percentile ≥ 95th) in comparison with those resulting from major trauma.
  
  
  METHODS
  This is a retrospective case-control study nested within a case series of 929 children, ages 0 to 17 years, with self-identified residence in Washington, DC, who were treated for isolated forearm fractures in an urban, academic pediatric emergency department between 2003 and 2006. Multivariable logistic regression was performed to test for the association of weight status with mechanism of injury while controlling for sex, age, race/ethnicity, bone fractured, and season.
  
  
  RESULTS
  Of 929 forearm fractures, there were 226 (24.3%) with ground-level falls and 54 (5.8%) with major trauma. Compared with children with forearm fractures resulting from major trauma, ground-level fall cases were significantly older (10.4 [3.4] vs 7.4 [4.2] years, P < 0.05), had greater adjusted odds of having a weight for age/sex of 95th percentile or higher (odds ratio, 2.7; 95% confidence interval, 1.2-6.5), and had significantly more radius-only fractures (odds ratio, 2.3; 95% confidence interval, 1.2-4.7). These groups did not differ in sex, race/ethnicity, or injury season.
  
  
  CONCLUSIONS
  Ground-level falls are a common mechanism of pediatric forearm fracture and are significantly associated with increased weight status and radius-only fractures. These results suggest the need for further investigation into obesity and bone health in pediatric patients with forearm fractures caused by ground-level falls.
authors.affiliation: From the *Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD; †Division of Emergency Medicine, and ‡Child Health Advocacy Institute, Children's National Medical Center; §Department of Emergency Medicine, George Washington University Medical Center; and ∥Department of Environmental and Occupational Health, George Washington University School of Public Health and Health Services, Washington, DC.
authors.forename: Leticia
authors.initials: L
authors.lastname: Manning Ryan
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Teach
authors.forename: Kimberle
authors.initials: K
authors.lastname: Searcy
authors.forename: Steven A
authors.initials: SA
authors.lastname: Singer
authors.forename: Rachel
authors.initials: R
authors.lastname: Wood
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Wright
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Hunting
authors.forename: James M
authors.initials: JM
authors.lastname: Chamberlain
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000293:Adolescent; D001835:Body Weight; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D005543:Forearm Injuries / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D010372:Pediatrics; D012189:Retrospective Studies; D012307:Risk Factors