Obesity as a Predictor of Outcomes in Type III and IV Supracondylar Humerus Fractures

To investigate the association of obesity with fracture characteristics and outcomes of operatively treated pediatric supracondylar humerus fractures. Retrospective multicenter. Two Level I pediatric hospitals. Patients (age < 18 years) with operatively treated Gartland type III and IV fractures 2010-2014. Closed or open reduction and percutaneous pinning of supracondylar humerus fractures. Incidence of Gartland IV fracture, pre-operative nerve palsy, open reduction and complication rates. Patients in the obese group had a significantly higher likelihood of having a Gartland IV fracture (NOT OBESE: 17%, OBESE: 35%, p =0.007). There was a significantly higher incidence of nerve palsy on presentation in the OBESE group (NOT OBESE: 20%, OBESE: 33%, p=0.03). No significant differences were found between groups regarding incidence of open reduction, compartment syndrome and rates of re-operation. The present study demonstrates that obese children with a completely displaced supracondylar humerus fractures have an increased risk of Gartland type IV and pre-operative nerve palsy compared to normal weight children. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.