Abstract
We thank the author for their thoughtful comments on our article “General anesthesia versus locoregional anesthesia in pediatric forearm fractures” (J Child Orthop 2025; 19(3): 242–247), and for highlighting the potential influence of body mass index on the rate of open reduction and anesthetic choice.
At our institution, systematic height measurement in pediatric patients is not routinely performed, except in cases involving growth disorders. Nevertheless, weight and age are recorded at the time of fracture, allowing classification according to the Centers for Disease Control and Prevention (CDC) growth charts. Based on these data, following your suggestion, we retrospectively identified obese patients—defined as weight above the 95th percentile for age and sex according to CDC criteria. 1
In our cohort, 16 out of 326 patients (4.9%) were classified as obese (6 in the general anesthesia group and 4 in the locoregional anesthesia group).
To address the concern raised, we re-analyzed our data after excluding all obese patients. This additional analysis did not change the overall results or the direction of our findings, confirming that the observed differences between anesthesia groups were not driven by the presence of obesity.
We acknowledge that obesity may influence fracture reduction, anesthetic management, and postoperative outcomes, and we fully agree that future prospective studies including standardized anthropometric data will help to further elucidate this issue.
We thank the correspondent for raising this valuable point, which contributes to improving the quality and interpretability of research in pediatric fracture care.
Sincerely,
Supplemental Material
sj-pdf-1-cho-10.1177_18632521251396637 – Supplemental material for Response to the letter on the role of body mass index in pediatric forearm fracture management
Supplemental material, sj-pdf-1-cho-10.1177_18632521251396637 for Response to the letter on the role of body mass index in pediatric forearm fracture management by Alessandro Aprato and Alessia Fierro in Journal of Children's Orthopaedics
Footnotes
Author contributions
Alessia Fierro re-analyzed the data, Alessandro Aprato was involved in manuscript conception, writing the manuscript, and contributed with important scientific knowledge, giving the final approval.
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Ethical approval
This retrospective study received a waiver from the local committee (Comitato etico Citt. della Salute e della Scienza di Torino 2018/20121), trial number 287.718 (April 14, 2020).
Consent to participate
Each patient gave written consent to participate.
Consent to publish
Each patient gave written consent to publish the results.
Data availability
All data have been stored in the dedicated repository of the University of Turin and are available on request to the corresponding author upon reasonable request.
References
Supplementary Material
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