Introduction-Although it has been suggested that overweight and obese children have an increased risk of fracture, recent studies in post-menopausal women have shown that the relationship between obesity and fracture risk varies by fracture site. We therefore assessed whether adiposity and overweight/obesity prevalence differed by upper limb fracture site in children.Methods-Height, weight, BMI, triceps and subscapular skinfold thickness (SFT) were measured in children aged 3-18 years with an acute upper limb fracture. Data was compared across three fracture sites (hand, forearm and upper arm/shoulder [UA]), and to published reference data.Results-401 children (67.1% male, median age 11.71 years (range 3.54-17.27 years) participated. 34.2%, 50.6% and 15.2% had fractures of the hand, forearm and UA, respectively. Children with forearm fractures had higher weight, BMI and SFT z-scores than those with UA fractures (p<0.05 for all). SFT z-scores were also higher in children with forearm fractures compared to hand fractures, but children withor hand and UA fractures did not differ. Overweight and obesity prevalence was higher in children with forearm fractures (37.6%) than those with UA fractures (19.0%, p=0.009). This prevalence was also higher than the published United Kingdom Conclusion-Measurements of adiposity and the prevalence of overweight/obesity differ by fracture site in children, and in particular boys, with upper limb fractures. Europe PMC Funders Group

Purpose-The diagnosis of osteoporosis in children requires either a vertebral compression fracture, or a significant fracture history (defined as ≥2 long bone fractures <10 years or ≥3 long bone fractures <19 years, excluding high impact fractures) and low bone mineral density. As children with frequent fractures might benefit from further evaluation, we determined whether parental reports of lifetime fracture were accurate compared to radiological reports, and if they appropriately selected children for further consideration of osteoporosis.Methods-Parents of children (<18 years) with a musculoskeletal injury completed a questionnaire on their child's fracture history, including age, site and mechanism of previous fracture(s). Radiological reports were reviewed to confirm the fracture.Results-660 parents completed the questionnaire, and reported 276 previous fractures in 207 children. An injury treated at our hospital was recorded in 214 of the 276 parentally reported fractures. 34 of 214 (16%) had not resulted in a confirmed fracture. An injury was recorded for all parentally reported fractures in 150 children, but for 21% children there were inaccurate details (no evidence of fracture, incorrect site or forgotten fractures) on parent report. 18/150 children had a significant fracture history on parental report alone, but following review of radiology reports, 2 of 18 (11%) did not have clinically significant fracture histories.Conclusions-Approximately 1 in 6 fractures reported by parents to have occurred in their child's lifetime had not resulted in a fracture. 1 in 9 children with a significant fracture history could have been investigated unnecessarily.

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