Bone fractures in children: is there an association with obesity?

OBJECTIVE

To determine the relationship between body mass index (BMI) and odds of extremity bone fractures in children.

STUDY DESIGN

This was a prospective cross-sectional study conducted at 2 tertiary care pediatric emergency departments. A convenience sample of children 2-17 years of age with a nonpenetrating extremity injury was enrolled. Demographics, activity level, mechanism of injury, participant BMI, and presence of a fracture were recorded. The main outcome was the odds of an extremity bone fracture based on BMI category; logistic regression was used to estimate the odds of fracture by BMI category.

RESULTS

We enrolled 2213 children, of whom 1078 (48.7%) sustained a fracture and 316 (14.3%) were classified as obese. The mean (SD) age was 9.5 (4.2) years, and percentage of male children was 56.8%. Compared with children with a normal BMI, the adjusted odds of fracture among obese, overweight, and underweight children were 0.75 (0.58, 0.97), 1.15 (0.89, 1.48), and 1.44 (1.00, 2.07) respectively.

CONCLUSIONS

Obese children had a minor but statistically significant decreased odds of fracture relative to children with a normal BMI, but no association was observed in overweight children. However, underweight children were found to be at an increased odds of fracture. This study suggests that overweight and obese children do not have increased odds of extremity fracture.