Background: In light of the increasing rate of obesity among
children in the United States, this study examines whether obese children have
an increased rate of complications following surgical treatment of femoral
Methods: A retrospective review of the charts of children between
six and fourteen years of age who were treated operatively for a femoral shaft
fracture was performed, and complications were identified.
Results: One hundred and three children (104 fractures), with a mean
age at the time of injury of 9.3 years, were identified. Fifty-nine fractures
were treated with external fixation, and forty-five were treated with an
intramedullary rod. Six children (6%) were considered obese, with a weight for
age at the 95th percentile or higher. An additional four children were
extremely heavy at the 90th to the 94th percentile of weight for age. Three
complications occurred in the six obese children, and one complication
occurred in the four extremely heavy children. Eleven (12%) of the remaining
ninety-three children had a complication. When examined according to treatment
groups, the complication rate for heavier children was higher for both the
group managed with an intramedullary rod and the group that had external
fixation (p = 0.004).
Conclusions: Obese children have an increased rate of postoperative
complications compared with children who are not obese. Therefore, parents of
obese children should be warned that such children may have a potentially
increased risk of complications associated with surgical management of a
Level of Evidence: Prognostic Level II. See Instructions
to Authors for a complete description of levels of evidence.