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Distal Radius Fractures Does Obesity Affect Fracture Pattern, Treatment and Functional Outcome
Michael D. Montague, MD; Jesse T. Lewis, MD; Jaiyoung Ryu, MD
West Virginia University, Morgantown, WV

Introduction: Current recommendations for treatment of distal radius fractures (DRF) have been provided by the American Academy of Orthopaedic Surgery however they fail to identify body habitus or obesity in their treatment algorithm. Despite addressing many issues surrounding the treatment of this relatively common injury, the guidelines make no mention of the role obesity might play in initial injury, treatment or outcomes.

Materials & Methods: A retrospective chart review of 122 adults who sustained a DRF after a fall from standing height was completed. All patients were treated by the senior author. Age at the time of injury, gender, and body mass index (BMI) was obtained. Radiographs at presentation were then classified by AO group (23-A, 23-B or 23-C). Distal radius fractures were categorized as simple (closed extra-articular (AO group 23-A) without an additional ipsilateral upper extremity fracture) or complex (intra-articular (AO groups 23-B and 23-C) or any open injury or with an additional ipsilateral upper extremity fracture). Chart review identified patients treated initially with surgery or non-operatively as well as those who failed non-operative management (in most cases due to loss of reduction). Patients were contacted and a QuickDASH score was obtained.

Results: The average age was 61.4 years of age (range 28-86). Average BMI was 28 (range 17.2-67.34). 84% were female. Those with a BMI >24 were more likely to have a complex DRF. Overweight/obese individuals were initially treated with surgery more often (80%) whereas only 60% of those with a BMI < 25 were treated initially with surgery.

Conclusions: Obesity is associated with a more complex fracture of the distal radius. Overweight and obese patients met operative parameters more frequently.

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