Location of Femoral Fractures in Patients with Different Weight Classes in Fall and Motorcycle Accidents: A Retrospective Cross-Sectional Analysis

Meng-Wei Chang, Hang-Tsung Liu, Chun-Ying Huang, Peng-Chen Chien, Hsiao-Yun Hsieh and Ching-Hua Hsieh
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Meng-Wei Chang: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
Hang-Tsung Liu: Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
Chun-Ying Huang: Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
Peng-Chen Chien: Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
Hsiao-Yun Hsieh: Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
Ching-Hua Hsieh: Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan

IJERPH, 2018, vol. 15, issue 6, 1-9

Abstract: Background: This study aimed to determine the incidence of femoral fracture location in trauma patients with different weight classes in fall and motorcycle accidents. Methods: A total of 2647 hospitalized adult patients with 2760 femoral fractures from 1 January 2009 to 31 December 2014 were included in this study. Femoral fracture sites were categorized based on their location: proximal femur (type A, trochanteric; type B, neck; and type C, head), femoral shaft, and distal femur. The patients were further classified as obese (body mass index [BMI] of ≥30 kg/m 2 ), overweight (BMI of <30 but ≥25 kg/m 2 ), normal weight (BMI of <25 but ≥18.5 kg/m 2 ), and underweight (BMI of <18.5 kg/m 2 ). Odds ratios and 95% confidence intervals of the incidences of femoral fracture location were calculated in patients with different weight classes in fall or motorcycle accidents, and they were then compared with those in patients with normal weight. p values of <0.05 were considered statistically significant. Results: Most of the fractures sustained in fall accidents presented in the proximal type A (41.8%) and type B (45.3%) femur, whereas those sustained in motorcycle accidents involved the femoral shaft (37.1%), followed by the distal femur (22.4%) and proximal type A femur (21.2%). In fall accidents, compared with normal-weight patients, obese and overweight patients sustained lower odds of risk for proximal type B fractures but higher odds of risk for femoral shaft and distal femoral fractures. In motorcycle accidents, compared with normal-weight patients, obese patients sustained lower odds of risk for proximal type B fractures but no difference in odds of risk for femoral shaft and distal femoral fractures. Overweight and underweight patients who sustained fractures in a motorcycle accident did not have different fracture location patterns compared with normal-weight patients. Conclusions: This study revealed that femoral fracture locations differ between fall and motorcycle accidents. Moreover, greater soft tissue padding may reduce impact forces to the greater trochanteric region in obese patients during fall accidents, and during motorcycle accidents, the energy transmitted and the point of impact may dominantly determine the location of femoral fractures.

Keywords: fall; femoral fracture; motorcycle; obese; overweight; trauma; underweight (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
References: View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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