Obese Teens May Be Plagued by Orthopedic Problems


Yesterday we mentioned research concerning the effect of fat when it colonizes muscle tissue. By some as yet unknown process, obesity seems to negatively affect bone development. Some bones are more vulnerable than others.

One of those is the distal radius, the thicker of the two forearm bones, near where it meets the hand. With an obese patient there are extra difficulties initially, and also later. When a bone is set, correct positioning is essential. With an obese patient, the medic has a harder time lining up the broken ends. After the fracture site is immobilized, the healing process is also more problematic for the obese.

Consequently, it begins to look as if using metal pins might be an orthopedist’s best practice, both for good alignment and speedier healing. This is good to know, but any surgical procedure opens up a whole new can of worms, so to speak. It might turn from an outpatient procedure to a hospital stay. The risk of infection goes up. And it will cost a lot.

The study that brought these things to light was presented at the 2014 American Academy of Orthopaedic Surgeons annual meeting. It included 157 children with distal radius fractures, of whom 42% were deemed overweight, and 29% were classified as obese, and…

[…] researchers found that obese children were significantly more likely to require a second surgical procedure to reposition their fractured bones. They were also more likely to need more follow-up visits requiring X-rays or other images.

And what of the upper arm, or humerus? According to the American Academy of Orthopaedic Surgeons:

Among other complications, obese children who sustain a supracondylar humeral (above the elbow) fracture can be expected to have more complex fractures and experience more postoperative complications than children of a normal weight…

Same goes for the femur, another study indicated. Seriously overweight kids need more extensive surgery, and experience more complications.

As always, the purpose for bringing up all this bad news is to emphasize, again and again, how essential it is to recognize and curb childhood obesity from the earliest possible moment. The sooner obesity begins, and the longer it goes on, the worse the potential for damage, including the appearance of co-morbidities that make life very complicated and unhappy.

In Overweight: What Kids Say, Dr Pretlow wrote:

If overweight kids need progressively larger amounts of pleasurable food or higher pleasure-level foods to feel satisfied or comforted, this would certainly worsen the childhood obesity epidemic and contribute to morbid obesity.

Morbid obesity is skyrocketing because cheap, high pleasure, high calorie food is becoming even more widely available, in the face of ever increasing tolerance. Furthermore, the stress of morbid obesity continually stokes the vicious cycle of spiraling comfort eating.

In the post “Advice to a British Mum,” Dr. Pretlow said this to a mother who was very concerned about her daughter:

A vicious circle will cease rotating if broken at any point on the circle… Each time she’s able to break a vicious circle for even just a bit, the circle will get smaller and easier to break the next time.

Your responses and feedback are welcome!

Source: “Childhood Obesity Linked to More Broken Wrists,” CounselHeal.com, 03/14/14
Source: “Obese Children More Likely to Have Complex Elbow Fractures, Further Complications,” ScienceDaily.com, 02/10/14
Source: “Overweight: What Kids Say,” Amazon
Photo credit: Birdies100 via Visualhunt/CC BY-SA

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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