Chronic Ankle Morbidity in Obese Children Following an Acute Ankle Injury

Objective To examine the relationship between childhood obesity as measured by body mass index (BMI) and long-term morbidity after an acute ankle sprain. Design Six-month prospective cohort study with follow-up telephone questionnaires at 6 weeks and 6 months. Setting Cincinnati Children’s Hospital Medical Center emergency department. Patients Children between the ages of 8 and 18 years who presented with a chief complaint of an acute ankle injury were enrolled in the study. Children with ankle fractures were excluded. Exposed children were defined as those with a BMI in the 85th or greater percentile for age. Nonexposed children were defined as those with a BMI in the less than 85th percentile for age. Main Outcome Measures Persistent symptoms of pain, swelling, or weakness; pain during or after exercise; and recurrent ankle injury. Results A total of 199 children were enrolled. The exposed and nonexposed groups were similar in terms of sex, age, and ethnicity. A total of 164 (93%) had complete follow-up at 6 months. Six months after an ankle injury, children with a BMI in the 85th or greater percentile for age were more likely to sustain persistent symptoms (relative risk, 1.70; 95% confidence interval, 1.10-2.61). Conclusion Overweight children are more likely to have persistent symptoms 6 months after an acute ankle sprain.