ﺑﺮرﺳﯽ ارﺗﺒﺎط ﺷﺎﺧﺺ ﺗﻮده ﺑﺪﻧﯽ در اﻃﻔﺎل زﯾﺮ 14 ﺳﺎل دﭼﺎر ﺷﮑﺴﺘﮕﯽ ﺑﺮﺟﺴﺘﮕﯽ ﺗﯿﺒﯿﺎ و آﺳﯿﺐ ﺑﻪ ﻟﯿﮕﺎﻣﺎن ﺻﻠﯿﺒﯽ ﻗﺪاﻣﯽ در ﺑﯿﻤﺎرﺳﺘﺎن ﺑﻌﺜﺖ ﻫﻤﺪان ﻃﯽ ﺳﺎلﻫﺎي 1390 ﺗﺎ 1391

Evaluation of Relationship between Body Mass Index and Tibial Eminent Fracture and ACL Injury in Children under 14 Years of Age, in a study at Beasat Hospital of Hamedan during 2011-12

زﻣﯿﻨﻪ و ﻫﺪف: ﺷﮑﺴﺘﮕﯽ ﺑﺮﺟﺴﺘﮕﯽ ﺗﯿﺒﯿﺎ ﻣﻤﮑﻦ اﺳﺖ در ﺗﻤﺎﻣﯽ ﺳﻨﯿﻦ دﯾﺪه ﺷﻮد، اﻣﺎ ﺷﺎﯾﻌﺘﺮﯾﻦ ﺳﻦ ﺑﺮوز اﯾﻦ ﻧﻮع ﺷﮑﺴﺘﮕﯽﻫﺎ در ﺑﭽﻪﻫﺎ و اﻓﺮاد 8 ﺗﺎ 14 ﺳﺎل ﻣﯽﺑﺎﺷﺪ. ﻣﺸﺨﺺ ﺷﺪه اﺳﺖ ﮐﻪ ﺷﯿﻮع ﺷﮑﺴﺘﮕﯽ از 16 درﺻﺪ در ﺑﭽﻪﻫﺎي ﺑﺎ وزن ﻃﺒﯿﻌﯽ ﺗﺎ 33 درﺻﺪ در ﺑﭽﻪﻫﺎي ﭼﺎق ﻣﺘﻔﺎوت اﺳﺖ. ﻫﻤﭽﻨﯿﻦ ﻣﻄﺎﻟﻌﺎت اﭘﯿﺪﻣﯿﻮﻟﻮژﯾﮏ ﻧﺸﺎن دادهاﻧﺪ ﮐﻪ ﺷﯿﻮع ﭼﺎﻗﯽ در ﻃﯽ ﺳﻪ دﻫﻪ اﺧﯿﺮ 2 ﺑﺮاﺑﺮ ﺷﺪه اﺳﺖ. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﺑﺮرﺳﯽ ارﺗﺒﺎط ﺑﯿﻦ ﺷﺎﺧﺺ ﺗﻮده ﺑﺪﻧﯽ ﺑﺎ ﺷﮑﺴﺘﮕﯽ ﺑﺮﺟﺴﺘﮕﯽ ﺗﯿﺒﯿﺎ اﻧﺠﺎم ﮔﺮدﯾﺪ. ﻣﻮاد و روش ﻫﺎ: در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻣﻮرد ﺷﺎﻫﺪي، 68 ﮐﻮدك ﮐﻤﺘﺮ از 14 ﺳﺎل ﻣﺮاﺟﻌﻪﮐﻨﻨﺪه ﺑﻪ ﺑﯿﻤﺎرﺳﺘﺎن ﺑﻌﺜﺖ ﻫﻤﺪان ﻣﻮرد ﻣﻄﺎﻟﻌﻪ ﻗﺮار ﮔﺮﻓﺘﻨﺪ، ﮐﻪ 34 ﻧﻔﺮ از آﻧﻬﺎ ﻣﺒﺘﻼ ﺑﻪ ﺷﮑﺴﺘﮕﯽ ﺑﺮﺟﺴﺘﮕﯽ ﺗﯿﺒﯿﺎ ﺑﻮدﻧﺪ )ﮔﺮوه ﻣﻮرد( و 34 ﻧﻔﺮ دﯾﮕﺮ از ﻣﯿﺎن ﺑﯿﻤﺎراﻧﯽ ﮐﻪ ﺑﻪ ﻋﻠﻞ دﯾﮕﺮ ﻣﺮاﺟﻌﻪ ﮐﺮده ﺑﻮدﻧﺪ، ﺑﻪ ﻋﻨﻮان ﮔﺮوه ﺷﺎﻫﺪ اﻧﺘﺨﺎب ﺷﺪﻧﺪ. ﺷﺎﺧﺺ ﺗﻮدة ﺑﺪﻧﯽ و ﻧﻮع اﺿﺎﻓﻪ وزن ﺑﺮ ﺣﺴﺐ ﺳﻦ و ﺟﻨﺲ ﺑﺮاي ﻫﺮ دو ﮔﺮوه ﻣﺤﺎﺳﺒﻪ ﮔﺮدﯾﺪﻧﺪ. در ﻧﻬﺎﯾﺖ اﻃﻼﻋﺎت ﺣﺎﺻﻠﻪ وارد ﻧﺮم اﻓـﺰار SPSS ﻧﺴﺨﻪ 18 ﮔـﺮدﯾﺪ و ﺑﺎ اﺳﺘﻔﺎده از آﻧﺎﻟﯿﺰ وارﯾﺎﻧﺲ و آزﻣﻮنﻫﺎي ﺗﯽ ﺗﺴﺖ و ﮐﺎي اﺳﮑﻮر ﻣﻮرد ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ آﻣﺎري ﻗﺮار ﮔﺮﻓﺖ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﻣﯿﺎﻧﮕﯿﻦ ﺷﺎﺧﺺ ﺗﻮدة ﺑﺪﻧﯽ در ﮔﺮوه ﻣﻮرد 20/98±3/88 و در ﮔﺮوه ﺷﺎﻫﺪ 20/47±2/93 ﺑﻮد )0/544=P(. در ﮔﺮوه ﻣﻮرد 18 ﺑﯿﻤﺎر )52/9%( از ﻧﻈﺮ وزﻧﯽ ﻧﺮﻣﺎل، 9 ﺑﯿﻤﺎر )26/5%( داراي اﺿﺎﻓﻪ وزن و 7 ﺑﯿﻤﺎر )20/6%( ﭼﺎق ﺑﻮدﻧﺪ. در ﮔﺮوه ﺷﺎﻫﺪ 19 ﺑﯿﻤﺎر )55/9%( از ﻧﻈﺮ وزﻧﯽ ﻧﺮﻣﺎل، 10 ﺑﯿﻤﺎر )29/4%( داراي اﺿﺎﻓﻪ وزن و 5 ﺑﯿﻤﺎر )14/7%( ﭼﺎق ﺑﻮدﻧﺪ )0/813=P(. ﻧﺘﯿﺠﻪ ﮔﯿـﺮي: ﻧﺘﺎﯾﺞ ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﻧﺸﺎن داد ﮐﻪ اﺿﺎﻓﻪ وزن و ﺷﺎﺧﺺ ﺗﻮدة ﺑﺪﻧﯽ ﮐﻮدﮐﺎن ﺗﺄﺛﯿﺮ ﻣﻌﻨﯽداري در ﻓﺮاواﻧﯽ ﺷﮑﺴﺘﮕي ﺑﺮﺟﺴﺘﮕﯽ ﺗﯿﺒﯿﺎ در آﻧﻬﺎ ﻧﺪارد.

Introduction & Objective: Tibial eminent fractures may be seen in all ages but the most common ages for the incidence of these fractures is in children of the 8 to 14 years. Recent studies have shown that the incidence of fractures in the children of normal weight is 16 percent, reaching 33 percent for obese children. Furthermore, epidemiological studies have shown that the prevalence of obesity has doubled over the past three decades. This study was performed to investigate the relationship between body mass index with tibial eminent fractures. Materials & Methods: In this case-control study, 68 children of the age less than 14 years, who referred to the Beasat Hospital of Hamadan were studied. Of these, 34 were suffering from tibial eminent fractures (case group) and 34 patients who had referred for other reasons were selected as the control group. BMI and type of weight by age and sex for both groups were calculated and compared. The results were analyzed, using SPSS18, variance analysis, T-test, and Chi-squared analysis. Results: The mean BMI in case group was 20.98 ± 3.88 and for the control group was 20.47 ± 2.93 (P=0.544). In the case group 18 patients (52.9%) of had normal weight, 9 patients (926.5%) were overweight, and 7 patients (20.6%) were obese .In the control group 19 patients (55.9%) had normal weight, 10 patients (29.4%) had overweight, and 5 patients (1407%) were obese (P=0.813). Conclusions: The results of this study showed that, children’s weight and body mass index have no significant effect on the tibial eminent fractures