Impact of Obesity on Pediatric Lower Limb Fractures and Treatment Outcomes: A Retrospective Cross-Sectional Study From a Tertiary Hospital in Northeastern Iran Publisher



Ghorbani M¹ ; Behjat M² ; Moghaddam MH³ ; Moghaddam SA⁴ ; Esmaeilian S⁵ ; Moshtaghioon SA⁶ ; Parsa A⁷ ; Rahmanipour E⁸
Source: Journal of Orthopaedic Reports Published:2025

Abstract

Introduction: This study aims to evaluate the obesity impact on lower limb fracture patterns and complications in children. Methods: The study included patients aged 1–14 years who visited emergency room or orthopedic clinic between 2012 and 2016. Demographic information, medical records, and procedures were analyzed. The diagnosis was based on age, Body Mass Index (BMI), gender, weight, height, type of trauma, and lower limb injuries. Data from physical examinations, imaging, treatment methods, surgery duration, complications, hospital stay, and recovery time were collected. Patients were categorized as underweight, normal weight, overweight, or obese based on BMI percentiles according to World Health Organization classifications, with gender-specific weight percentiles applied. Results: The study included 247 pediatric patients, comprising 178 boys and 69 girls. The patients' ages ranged from 13.4 to 161.7 months, with an average BMI of 17.45 ± 2.30 kg/m2. Among the participants, 8.5 % were underweight, 47.8 % were normal weight, 25.5 % were overweight, and 18.2 % were obese. The most common fracture sites were the femur (38.1 %), leg (32.4 %), and foot (17 %). The mean hospitalization duration was 8.04 ± 4.89 days. Complications were documented in 11 cases, with malunion occurring predominantly in the overweight and obese groups. Statistically significant differences in age and hospitalization duration were observed across the weight categories (p < 0.05). Furthermore, a strong positive correlation was identified between BMI and length of hospital stay (correlation coefficient = 0.728; p < 0.001). Conclusion: The study revealed that BMI did not significantly affect the distribution of fractures, patient status, or mode of admission. However, it had a notable impact on outcomes and clinical findings. Overweight and obese patients experienced longer hospital stays and a higher incidence of complications, with malunion being the most frequently observed issue. © 2025 The Authors