Distal Radius Fractures: Does Obesity Affect Fracture Pattern,Treatment,and Functional Outcomes?

Abstract

Background: Distal radius fractures (DRFs) are 16% of fractures treated by orthopedic surgeons. Obesity’s influence on DRF complexity has not been studied. This study was undertaken to determine if body mass index (BMI) affects DRF pattern, treatment, and functional outcomes. Methods: Part 1 was a retrospective review of patients who sustained a DRF after a fall from standing height with no prior reduction or treatment. Radiographs were classified as “simple” or “complex.” Part 2 consisted of contacting patients from Part 1 and obtaining a Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score. Retrospective review also identified patients who failed initial nonoperative treatment. Fracture pattern, failure of nonoperative treatment, and QuickDASH scores were compared with BMI at the time of injury. Results: For Part 1, 130 patients (132 wrists) were identified. Average age was 57 years, 77% were female, and average BMI was 28.2 kg/m². Each point increase in BMI increased the chance of having a complex DRF (odds ratio = 1.07). Part 2 identified 50 patients who completed a QuickDASH at an average of 4.6 years after injury. Those with a BMI <25 kg/m² (n = 15) had an average QuickDASH score of 37; patients with a BMI ≥25 kg/m² (n = 35) had an average QuickDASH score of 18. Increasing BMI was suggestive of a lower QuickDASH score (P = .08). No significant difference was found with respect to BMI and failure of nonoperative treatment. Conclusions: A higher BMI increases the odds of a complex DRF. Despite more complex fractures, overweight patients may experience less disability after sustaining a DRF.