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Current Concepts Review   |    
Effects of Obesity on Pediatric Fracture Care and Management
Meredith A. Lazar-Antman, MD1; Arabella I. Leet, MD2
1 Pediatrics Division, Department of Orthopaedic Surgery, Winthrop-University Hospital 222 Station Plaza North, Suite 305, Mineola, NY 11501. E-mail address: Meredith.lazar@gmail.com
2 Department of Orthopaedic Surgery, Shriners Hospital for Children-Honolulu, 1310 Punahou Street, Honolulu, HI 96826. E-mail address: Aleet@shrinenet.org
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Investigation performed at the Pediatrics Division, Department of Orthopaedic Surgery, Winthrop-University Hospital, Mineola, New York, and Johns Hopkins University, Baltimore, Maryland



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 May 02;94(9):855-861. doi: 10.2106/JBJS.J.01839
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Abstract

Obese children have a theoretically increased risk of sustaining an extremity fracture because of potential variations in their bone mineral density, serum leptin levels, and altered balance and gait.

Trauma databases suggest an increased rate of extremity fractures in obese children and adolescents involved in polytrauma compared with nonobese children and adolescents.

Anesthetic and other perioperative concerns for obese pediatric trauma patients undergoing surgery include higher baseline blood pressures, increased rates of asthma, and obstructive sleep apnea.

A child’s weight must be considered when choosing the type of implant for fixation of pediatric femoral fractures.

Fracture prevention strategies in obese pediatric patients consist of ensuring properly sized safety gear for both motor vehicles and sporting activities and implementing structured weight-loss programs.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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