Obesity as a Predictor of Outcomes in Type III and Type IV Supracondylar Humerus Fractures

Objectives: To investigate the association of obesity with fracture characteristics and outcomes of operatively treated pediatric supracondylar humerus fractures. Design: Retrospective multicenter. Setting: Two Level I pediatric hospitals. Patients: Patients (age <18 years) with operatively treated Gartland type III and type IV fractures 2010-2014. Intervention: Closed or open reduction and percutaneous pinning of supracondylar humerus fractures. Main Outcome Measure: Incidence of Gartland IV fracture, preoperative nerve palsy, open reduction and complication rates. Results: Patients in the obese group had a significantly higher likelihood of having a Gartland IV fracture (not obese: 17%; obese: 35%; P = 0.007). There was a significantly higher incidence of nerve palsy on presentation in the obese group (not obese: 20%; obese: 33%; P = 0.03). No significant differences were found between groups regarding incidence of open reduction, compartment syndrome, and rates of reoperation. Conclusions: The present study demonstrates that obese children with a completely displaced supracondylar humerus fractures have an increased risk of Gartland type IV and preoperative nerve palsy compared with normal weight children.

Automated summary

The study demonstrates that obese children with completely displaced supracondylar humerus fractures have a higher risk of Gartland type IV fractures and preoperative nerve palsy compared to normal weight children. However, there were no significant differences between the obese and non-obese groups in terms of open reduction, compartment syndrome, and reoperation rates.