Childhood Obesity and Low-Velocity Knee Dislocation in a Fifteen-Year-Old Girl

Abstract

According to the 2007-2008 National Health and Nutrition Examination Survey (NHANES), an estimated 17% of children and adolescents between the ages of two and nineteen years are overweight1. The survey data indicated that there was an increase in the prevalence of obesity in children and adolescents in the United States during the years 1976 through 1980 and the years 1999 through 2000. Among two-year-olds to five-year-olds, the percentage has increased from 5% to 10.4%, and among six-year-olds to eleven-year-olds, from 6.5% to 19.6%1. The comorbidities often associated with obesity include diabetes, atherosclerosis, sleep apnea, and coronary artery disease. Musculoskeletal injuries are less often associated with obesity. Minor trauma in overweight individuals can cause serious injuries similar to those caused by high-velocity accidents, with the most notable injury being knee dislocation2. These injuries have been documented mostly in obese adults; however, to our knowledge, the youngest person to have sustained a low-velocity knee dislocation was a nineteen-year-old3. In this report, we document a fifteen-year-old obese girl who sustained a knee dislocation with serious complications due to a ground-level fall. To our knowledge, this is the youngest patient with this injury to be reported in the literature. The patient and her parents were informed that data concerning the case would be submitted for publication, and they consented. A fifteen-year-old obese girl (weight, 113 kg; height, 167 cm; body-mass index, 40.5 kg/m2) injured her right knee after falling over a friend’s leg while playing at school. On initial evaluation at an outside institution, she was noted to have posterior dislocation of the right knee (Figs. 1-A and 1-B) and no pulse in the involved extremity. The knee was reduced with traction, but the limb remained pulseless. The patient was transferred to the regional pediatric …