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. 2022 Mar 17;9(3):425.
doi: 10.3390/children9030425.

Is Obesity a Risk Factor for Loss of Reduction in Children with Distal Radius Fractures Treated Conservatively?

Andrea Vescio  1 , Gianluca Testa  1 , Marco Sapienza  1 , Alessia Caldaci  1 , Marco Montemagno  1 , Antonio Andreacchio  2 , Federico Canavese  3 , Vito Pavone  1
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Is Obesity a Risk Factor for Loss of Reduction in Children with Distal Radius Fractures Treated Conservatively?

Andrea Vescio et al. Children (Basel). .

Abstract

Background: Obesity in children is a clinical and social burden. The distal radius (DR) is the most common site of fractures in childhood and conservative treatment is widely used. Loss of reduction (LOR) is the major casting complication. The aim of this study is to evaluate obesity as a risk factor for LOR in children with displaced DR fractures (DRF) treated conservatively. Methods: 189 children under 16 years of age were treated conservatively for DRF. Patients were divided into three groups: normal weight (NW), overweight (OW) and obese (OB). The following radiographic criteria were evaluated in all patients: amount of initial translation (IT); quality of initial reduction; Cast (CI), Padding (PI), Canterbury (CaI), Gap (GI) and Three-Points (3PI) indices and the presence of LOR. Results: Statistically significant differences were found between the NW and the OB group for number of LOR (p = 0.002), severity (grade) of initial translation (p = 0.008), quality of initial reduction (p = 0.01) as well as CsI and CaI (p < 0.001). Conclusions: Obese children have a significantly higher rate of LOR compared to NW and OW children. A close follow-up is necessary in this population of patients. Preventive percutaneous pinning could be considered in older obese patients in order to reduce the need for further treatment.

Keywords: childhood obesity; conservative treatment; distal radius fracture; loss of reduction; secondary displacement.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A comparison of the lateral view of the fat layer (red lines) at a fracture site (green lines) between (a) an obese patient and (b) a patient of normal weight matched for age and gender.
Figure 2
Figure 2
Case report of an obese patient. (a) Post-reduction casting X-ray; (b) one-week post-reduction X-ray with loss of reduction; (c) surgical treatment of the fracture.
Figure 2
Figure 2
Case report of an obese patient. (a) Post-reduction casting X-ray; (b) one-week post-reduction X-ray with loss of reduction; (c) surgical treatment of the fracture.
See this image and copyright information in PMC

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