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.

LEVEL OF EVIDENCE

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.