Date of Award


Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Eugene D. Shapiro


Pediatric obesity has become a worldwide pandemic and trauma is the leading cause of pediatric morbidity and mortality. Our hypothesis is that being overweight increases the likelihood of acute ankle injuries in children. Our study consisted of a case-control analysis in an urban pediatric emergency department with subjects between 5-19 years of age. Cases consisted of children presenting with acute ankle injury; controls had chief complaints of fever, headache, or sore throat. Demographic information, physical activity score, heights, and weights were obtained on all participants; injury severity was calculated for the cases. Age and gender specific body mass index percentiles were calculated for all participants and a multivariate logistic regression was employed to assess the association between overweight and ankle injury. We also examined those ankle injuries that were not enrolled to asses for possible enrollment bias through comparison of weight percentiles and a sensitivity analysis of increasingly more unlikely assumptions. One hundred and eighty cases and 180 controls were enrolled. A significant association was observed between overweight and ankle injuries (multivariate-adjusted odds ratio 3.26, 95% confidence interval 1.86-5.72, P value for trend < 0.0001). Due to possible enrollment bias, this result might overestimate the magnitude of the association, however our sensitivity analysis demonstrated the robustness of the statistical significance of our findings. In summary, overweight children may be at increased risk for acute ankle injuries.