Obese kids were nine times more likely to suffer an
elbow fracture with multiple fracture lines in the same arm, or with
the bone exposed through the skin, compared to normal-weight
children, researchers found. Obese kids were also more likely to
have fallen on their outstretched hand.
"As a public health message, this study validates the efforts of
medical organizations to raise awareness about childhood obesity,"
Dr. Michelle Caird told Reuters Health.
"And I think it opens up a conversation about building and
maintaining skeletal health," she said. "The skeleton structurally
and metabolically supports the human body," she added.
Caird, an orthopedic surgeon, led the study from the University of
Michigan C.S. Mott Children's Hospital in Ann Arbor.
She and her team analyzed the health records of 354 children who
underwent surgery at that hospital for elbow fractures between 1999
Ninety-two injuries happened on monkey bars or trampolines and 88
fractures occurred from a fall at a standing height.
Additionally, obese kids were more likely to experience nerve palsy
Boys made up a little over half of the sample and patients averaged
6 years old. Most kids in the study were normal weight, but the
group included underweight, overweight and obese children.
About 17 percent of American kids could be classified as obese,
according to the U.S. Centers for Disease Control and Prevention.
The CDC categorizes a child's body mass index (BMI), a measure of
weight relative to height, by comparing it to other children in the
same age group.
For example, a 6-year-old boy who stands three feet, six inches and
weighs 60 pounds would fall in the 99th percentile for his age. This
means that 99 percent of kids in the U.S. have a lower BMI. In the
current study, kids with a BMI higher than the 95th percentile were
The researchers point out in the Journal of Bone & Joint Surgery
that their study doesn't delve into the "why" behind complicated
elbow fractures in heavy kids.
But past research offers some possible explanations, Caird said. For
example, some evidence links high-fat diets with hampering the
body's ability to absorb calcium and Vitamin D in the bones. Other
studies have suggested that since obese children tend to be more
inactive in general, their balance and movement may not be as sharp
as normal-weight kids, Caird said.
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"There isn't enough data available in the literature to assess
whether or not the findings of the current study are representative
of the broader national experience," Dr. Marc Michalsky told Reuters
Michalsky, who was not involved in the study, is surgical director
of the Center for Healthy Weight and Nutrition at Nationwide
Children's Hospital in Columbus, Ohio.
Research on pediatric fractures among obese kids is such a new field
that it's difficult to know if the high risk is an expected, low or
high statistic, he said.
Besides serving as a reminder of the ongoing U.S. obesity
epidemic, the study highlights "significant health differences
between obese and non-obese populations," Michalsky said.
Caird pointed out that the best time for growing strong, healthy
bone mass is during childhood.
"We can grow bone mass only until we are about 30 years old," she
Kids of all sizes who exercise should all follow proper safety
precautions when playing sports or being active, like wearing
helmets or joint guards, Michalsky said.
"The last thing we want to do is avoid physical activity," he said.
The Journal of Bone & Joint Surgery, online February 5, 2014.
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