Prevalence of Fracture of Forearm Bones in Obese and Non-obese Children: A Cross-sectional Study

Abstract

Introduction: Through much history of mankind, the overt manifestation of bodyweight gain in children and adults have been considered as a sign of personal health and family wealth and an indicator of the economic prosperity of the society. As developing societies are industrialised and urbanised, the standards of living continued to rise; obesity and weight gain began to pose a growing threat to the health of the citizens. Aim: To determine the prevalence of forearm bones fracture in obese and non-obese children between age group of 2-15 years. Materials and Methods: A cross-sectional study was conducted in the Department of Orthopaedics and Paediatrics at Dr BC Roy Post Graduate Institute of Paediatric Science, Kolkata, West Bengal, India from September 2017 to October 2018. Children were classified into obese and non-obese group according to Body Mass Index (BMI). Calculation of BMI was done by the formula BMI=weight (kg)/{height(m)}2. Obese children were determined by the BMI percentile by plotting the BMI number on the appropriate Centers for Diseases Control and Prevention (CDC) BMI-for-age growth chart. Doubtful cases classification was confirmed by the paediatric surgeon. Injury mechanism was graded into three trauma kinetics (direct trauma, slow motion trauma and high motion trauma). The validated paediatric Physical Activity Questionnaire (PAQ-A and PAQ-C) were used to grade the average daily activities during the week prior to trauma. Statistical analysis was done by using the Chi-square test and p-value of <0.05 was considered to be statistically significant. Results: Total 583 children were treated during the study period in the hospital including both Outpatient Department (OPD) and Emergency Department. About 433 children were excluded due to below age two years, refracture, chronic illness, and major congenital malformation. Among them only 150 patients met the criteria of present study. Out of 150 children, 69 (46%) were found obese and non-obese were 81 (54%). The distribution by gender was the same in obese group which had 26 (37.68%) female and 43 (62.32%) male, in non-obese group 34 (41.97%) female and 47 (58.03%) male. It was observed that both bones fracture of forearm in obese children was more at risk than non-obese children, p-value of <0.5 which was statistically significant. Conclusion: Present study shows higher prevalence of forearm bone fracture in obese children than non-obese children. Obesity and other certain factors might have been significant risk factor for fracture required for operation. Both radius-ulna fracture in obese were found significant.