Vescio Andrea, Testa Gianluca, Sapienza Marco, Caldaci Alessia, Montemagno Marco, Andreacchio Antonio, Canavese Federico, Pavone Vito
Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, Italy.
Department of Pediatric Orthopedic Surgery, "V. Buzzi" Children Hospital, 20154 Milan, Italy.
Children (Basel). 2022 Mar 17;9(3):425. doi: 10.3390/children9030425.
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.
儿童肥胖是一种临床和社会负担。桡骨远端是儿童骨折最常见的部位，保守治疗被广泛应用。复位丢失是主要的石膏固定并发症。本研究的目的是评估肥胖作为保守治疗的移位桡骨远端骨折（DRF）患儿复位丢失的危险因素。方法：189例16岁以下儿童接受DRF保守治疗。患者分为三组：正常体重（NW）、超重（OW）和肥胖（OB）。对所有患者评估以下影像学标准：初始移位量（IT）；初始复位质量；石膏（CI）、衬垫（PI）、坎特伯雷（CaI）、间隙（GI）和三点（3PI）指数以及复位丢失的情况。结果：NW组和OB组在复位丢失数量（p = 0.002）、初始移位严重程度（分级）（p = 0.008）、初始复位质量（p = 0.01）以及CsI和CaI（p < 0.001）方面存在统计学显著差异。结论：与NW和OW儿童相比，肥胖儿童的复位丢失率明显更高。对该患者群体进行密切随访是必要的。对于年龄较大的肥胖患者，可以考虑预防性经皮穿针固定，以减少进一步治疗的需求。
