Obesity Increases Complexity of Distal Radius Fracture in Fall From Standing Height

Objectives: To investigate the relationship between obesity and distal radius fracture severity after low-energy trauma and to identify patient-specific risk factors predictive of increasing fracture severity. Design: Retrospective review. Setting: Level 1 Trauma Center. Patients/Participants: Four hundred twenty-three adult subjects with a history of fracture of the distal radius resulting from a fall from standing height. Intervention: Demographic data and injury characteristics were obtained. Preoperative wrist radiographs were reviewed and classified by the OTA classification system. Distal radius fractures were categorized as simple [closed and extra-articular (OTA 23-A)] and complex [intra-articular (OTA 23-B or 23-C) or open fracture or concomitant ipsilateral upper extremity fracture]. Multivariate logistic regression was completed to model the probability of incurring a complex fracture. Main Outcome Measurements: Simple versus complex fracture pattern. Results: Average age at the time of injury was 53.8 years (range, 18.9-98.4). Seventy-nine percent of subjects were female. The average body-mass index was 28.1 (range, 13.6-59.5). Two hundred forty-four patients (58%) suffered complex distal radius fractures per study criteria. Obese patients (body-mass index > 30) demonstrated increased fracture severity as per the OTA classification (P = 0.039) and were more likely to suffer a complex injury (P = 0.032). Multivariate regression identified male gender, obesity, and age >50 as independent risk factors for sustaining a complex fracture pattern. Conclusions: Obesity is associated with more complex fractures of the distal radius after low-energy trauma, particularly in elderly patients. This relationship may have important epidemiologic implications predictive of future societal fracture burden and severity in an obese, aging population.