The Relationship Between Obesity and Lateral Condyle Fracture Healing: A Pilot Study.

Objective: Childhood obesity is a growing public health concern in the United States. Obesity has been shown to lead to increased complications with regards to orthopaedic injuries, such as more severe fracture patterns, notably observed in injuries like lateral condyle fractures of the humerus. However, there is currently a gap in the literature regarding the relationship between obesity and the healing potential of these fractures. This study aims to determine whether obesity is associated with increased surgical time, wound/pin site infections, delayed union/nonunion, and time to union in pediatric patients with lateral condyle fractures of the humerus.

Methods: A retrospective chart review was conducted at a level 1 trauma center on all patients 18 years or younger who sustained a lateral condyle fracture of the humerus. Patients were stratified into groups based on their body mass index-for-age percentile as defined by the Centers for Disease Control and Prevention; normal weight (<85%), overweight (85 to <95%), and obese (≥95%). Demographic data, Weiss classification, postoperative complications (infection, delayed union or nonunion, malunion, and need for repeat surgery), length of surgery, and time to union were recorded. Comparisons of categorical data were analyzed using χ2 tests. Analysis of variance was used to compare the means between weight cohorts for continuous data.

Results: A total of 123 patients were analyzed. Sixty-six were categorized as normal weight, 20 were overweight, and 37 were obese. There were no significant differences between weight classes for any complications, including infection, delayed/nonunion, malunion, or repeat surgery. There was no correlation with fracture severity as defined by the Weiss classification of lateral condyle fractures in regards to weight cohort (P = 0.098). There was no significant difference in length of surgery (P = 0.393) or average time to union (P = 0.236) between the weight cohorts.

Conclusion: In this study, population with higher pediatric obesity rates than the population average, there was no significant correlation between body mass index-for-age and each of the surgical complications reviewed, length of surgery, or time to union, indicating the healing potential of lateral condyle fractures in obese pediatric patients is no more compromised than that of their normal weight peers.

Level of evidence: Level III-a retrospective study.