title: Obesity Increases Complexity of Distal Radius Fracture in Fall From Standing Height.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Level 1 Trauma Center.
  
  
  METHODS
  Four hundred twenty-three adult subjects with a history of fracture of the distal radius resulting from a fall from standing height.
  
  
  METHODS
  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.
  
  
  METHODS
  Simple versus complex fracture pattern.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA; and †Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ebinger
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Koehler
authors.forename: Lori A
authors.initials: LA
authors.lastname: Dolan
authors.forename: Katelyn
authors.initials: K
authors.lastname: McDonald
authors.forename: Apurva S
authors.initials: AS
authors.lastname: Shah
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence; D011885:Radius Fractures / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015599:Trauma Severity Indices; D000092464:Elbow Injuries