Complications with flexible nailing of femur fractures more than double with child obesity and weight >50 kg

Background Previous studies report that children above the 95th percentile in weight for their age had an increased risk for complications following titanium elastic nailing for femur fractures. The purpose of this study is to examine whether obesity, defined as body mass index (BMI) > 95th percentile, and/or simple weight correlates with an increased rate of complications. Methods The incidence of complications was compared between obese and non-obese patients and also between patients who weighed >= 50 kg and those < 50 kg. Results The overall complication rate was 23% (16/71). The complication rate was 17% (10/58) for "non-obese'' patients and 46% (6/13) for "obese'' patients. This difference was statistically significant (P = 0.03). The complication rate was 46% (6/13) in children who weighed >= 50 kg and 17% (10/58) in children who weighed < 50 kg. This difference was also statistically significant (P = 0.03). Conclusions This study demonstrates that obesity (BMI > 95th percentile) and weight over 50 kg predispose patients to increased risk of surgical complications when undergoing flexible elastic nailing for femur fractures. Both obese children and children weighing >= 50 kg were two times more likely to have a complication when undergoing this procedure.