ISSN 2052-1219 (online)

Bone Abstracts (2015) 4 OP10 | DOI: 10.1530/boneabs.4.OP10

Does degree of adiposity influence upper limb fracture site in children?

Rebecca Moon1,2, Adelynn Lim1, Megan Farmer1, Avinash Segaran1, Nicholas Clarke3, Nicholas Harvey2, Elaine Dennison2, Cyrus Cooper2 & Justin Davies1

1Paediatric Endocrinology, University Hospitals Southampton NHS Foundation Trust, Southampton, UK; 2MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; 3Paediatric Orthopaedics, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Although it has been suggested that overweight and obese children have an increased risk of fracture, recent studies in post-menopausal women have shown that the relationship between obesity and fracture risk varies by fracture site. Thus, obesity is protective against wrist fractures but confers an increased risk of humeral fractures. There are no data to suggest whether this observation is also present in children. We therefore assessed whether adiposity and overweight/obesity prevalence differed by upper limb fracture site in children.

Height, weight, BMI, triceps and subscapular skinfold thickness (SFT) were measured in children aged 3–18 years with an acute upper limb fracture. Overweight and obesity were defined as a BMI z-score ⩾1.036 (85th centile) and ⩾1.645 (95th centile) respectively to allow comparison to the 2012 United Kingdom Health Survey for England prevalence of childhood overweight and obesity (27.9%). Data was compared across three fracture sites (hand, forearm and upper arm/shoulder (UA)).

401 children (67.1% male, median age 11.7 years (range 3.5–17.3 years)) participated. 34.2%, 50.6% and 15.2% had fractures of the hand, forearm and UA respectively. After adjustment for age and sex, children with forearm fractures had higher weight, BMI and SFT z-scores than those with UA fractures (P<0.05 for all). There were no differences between children with hand and forearm or hand and UA fractures.

Overweight and obesity were more prevalent in children with forearm fractures (37.6%) than those with UA fractures (19.0%, P=0.009). In comparison to United Kingdom population, the prevalence of overweight and obesity was higher in children with forearm fractures (p=0.003), whereas children with either UA (P=0.13) or hand fractures (29.1%, P=0.76) did not differ.

Measurements of adiposity and the prevalence of overweight/obesity differed by fracture site in children with upper limb fractures. Children with forearm fractures had the highest indices of adiposity.

Disclosure: The authors declared no competing interests.

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