DENVER – An underappreciated consequence of the childhood obesity epidemic is an increase in pediatric forearm fractures resulting from a fall from standing height.
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Children with a forearm fracture from a standing-height fall were 2.4-fold more likely to be above the 95th percentile for weight.
A retrospective study of Washington, D.C.–area children and adolescents who were treated for an isolated forearm fracture in the emergency department of Children’s Hospital National Medical Center demonstrated that kids with a forearm fracture resulting from a standing-height fall were 2.4-fold more likely to be at or above the 95th percentile for weight for age and sex than were kids whose forearm fracture resulted from major trauma, Dr. Leticia M. Ryan reported at the annual meeting of the American Public Health Association.
This finding provides yet another sound rationale for aggressively addressing the pediatric obesity epidemic, added Dr. Ryan of the division of emergency medicine at George Washington University in Washington.
Of the 929 youths younger than age 18 years without known bone mineralization disorders who were treated in the ED for an isolated forearm fracture during 2003-2006, 24.3% were injured through a standing-height fall. The comparison group consisted of the 5.8% of patients whose forearm fracture resulted from major trauma.
The radius was the only forearm bone broken in 52% of patients with a standing-height fall, whereas another 46% had fractures of both the radius and ulna, and the remaining 2% had fractures of the ulna only. In contrast, only one-third of patients with major trauma had a radius-only forearm fracture.
The prevalence of weight for age and sex in the 95th percentile or above was 32.4% among patients with a standing-height fall as their fracture mechanism, compared with 15.7% in those with major trauma.
The largest number of forearm fractures occurred in children aged 5-9 and 10-14 years. Children aged 5-9 years with a standing-height fall were 5.2-fold more likely to meet or exceed the 95th percentile of weight for age and sex, compared with kids in the same age group with major trauma. Among 10- to 14-year-olds with a forearm fracture, those who experienced a standing-height fall were 1.7-fold more likely to be in at least the 95th percentile.
This study was funded by the National Institutes of Health and Children’s National Medical Center. Dr. Ryan declared having no relevant financial interests.