Adult ankle fractures—an increasing problem?

Court-Brown, Charles M.; McBirnie, Julie; Wilson, Guineva

doi:10.3109/17453679809002355

Cited by 568 publications

(380 citation statements)

References 8 publications

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“…The annual incidence of ankle fracture is between 107 and 187 per 100,000 persons [4][5][6] , and around 2% of ankle fractures are open fractures [4] . Ankle fractures usually affect young men and older women, however, below the age of 50 ankle fractures are the commonest in men.…”

Section: Introductionmentioning

confidence: 99%

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A retrospective study of functional outcome of surgically managed malleolar fracture at the ankle joint by subjective, objective and radiological assessment

Sultanpurkar¹,

Haranadh²,

Vikram³

et al. 2017

Int. J. Orthop. Sci.

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Objective: To study the functional outcome of surgically managed malleolar fractures at ankle and to assess the results of complication. Introduction: Ankle fracture is a common injury with potentially significant morbidity associated with it. Regardless of the method of the intervention, main goal is to restore normal anatomy. Complications associated with both conservative and operative management are an important consideration in decision making. Patient selection is very important in deciding the type of management. This paper provides an update to surgical management of ankle fractures. Methodology: Medical records of 96 patients were studied and data was collected which includes the demographic data, fracture details, intraoperative and postoperative details. Then patients were called up for follow-up. The functional outcome of these patients was assessed subjectively using OLERUD MOLANDER ANKLE SCORE (OMA) score. Objective and radiological outcome was assessed using cedell's criteria. Results: Among the 96 patients we achieved excellent and good subjective results in 60 (62.5%) patients; Good objective result in 72 (75%) patients; Good radiographic results in 80 (83.4%) patients. In our study, patients with unimalleolar fractures had the best outcome. Trimalleolar fractures had the worst outcome. Bimalleolar fracture had intermediate outcome. With regards to lateral malleolar fracture fixation modality, patients with rush nail achieved good to fair radiological and objective outcome with no poor outcomes With regards to medial malleolar fracture fixation modality, patients with Tension band achieved good objective and radiological outcome and there were no poor outcomes. In patients with malleolar screw fixation 62.5 % patients achieved good objective and 75 % patients achieved good radiological outcome. Patients with complications has poorer outcome. In patients with superficial infection the outcome was poorer.

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Section: Introductionmentioning

confidence: 99%

“…Alcohol and slippery surfaces are each involved in nearly a third of the cases [6] . Twisting injuries and falls, followed by sports injuries [4] are the most common causes of ankle injuries. Diabetes and obesity are associated with fractures in middle aged and older adults [5] .…”

Section: Introductionmentioning

confidence: 99%

A retrospective study of functional outcome of surgically managed malleolar fracture at the ankle joint by subjective, objective and radiological assessment

Sultanpurkar¹,

Haranadh²,

Vikram³

et al. 2017

Int. J. Orthop. Sci.

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“…Falls (both slips and trips) commonly cause fractures to bones of the wrist when an individual tries to break their impact with an outstretched hand (Nevitt and Cummings 1993;Verma et al 2008). Another type of underfoot injury, regularly caused by ankle instability on uneven surfaces, results in oblique or avulsion fractures to the distal part of the tibia or fibula due to abrupt over-pronation or supination of the foot at the ankle joint (Cooper 2000;Court-Brown et al 1998;Donatto 2001;Manning 1983). These types of fractures have been previously observed in other Roman provincial contexts (e.g.,…”

Section: Introductionmentioning

confidence: 99%

Gendered Differences in Accidental Trauma to Upper and Lower Limb Bones at Aquincum, Roman Hungary

Gilmour

Gowland

Roberts

et al. 2015

International Journal of Paleopathology

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Additional information:Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. AbstractIt is hypothesized that men and women living in the border provinces of the Roman Empire may have encountered different physical dangers associated with variation in their occupations and activities. Limb bone trauma data were used to assess sex-based differences in physical hazards and evidence for fracture healing and treatment. Two hundred and ten skeletons were examined from a late 1 st to early 4 th century AD cemetery at Aquincum (Budapest, Hungary). Upper and lower limb bone fracture types, frequencies, distributions, and associated complications were recorded, and gendered patterns in injury risks were explored. Of the 23 fractures identified, both sexes had injuries indicative of falls; males exhibited the only injuries suggestive of higherenergy and more direct forces. Most fractures were well-healed with few complications. The extremity trauma at Aquincum suggests that people buried here experienced less hazardous physical activities than at other Roman provincial sites. The patterns of trauma indicate that "traditional" gender roles were in place, whereby male civilians participated in more physically dangerous activities than females. Additionally, treatment may have been equally accessible to men and women, but certain fracture types proved more challenging to reduce using the techniques available.

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“…Between 60 % and 70 % are unimalleolar fractures, the majority involving the lateral malleolus [5,6]. Posterior malleolus fractures occur in 7-44 % of ankle fractures [4,5,11,18].…”

Section: Introductionmentioning

confidence: 99%

The effect of minimally displaced posterior malleolar fractures on decision making in minimally displaced lateral malleolus fractures

Palmanovich

Brin

Laver

et al. 2013

International Orthopaedics (SICOT)

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Purpose Despite the high incidence of cases of minimally displaced lateral or posterior malleolus ankle fractures, treatment guidelines are still an issue of controversy. The purpose of this study was to delineate treatment preferences among orthopaedic surgeons in these fractures with and without concomitant posterior malleolus fractures. We hypothesized that concomitant minimally displaced fractures of the posterior malleolus can shift treatment preference towards operative intervention. Methods A questionnaire-based study was conducted among orthopaedic surgeons attending the 2012 European Federation of National Associations of Orthopaedics and Traumatology Conference (EFORT) in Berlin, Germany. Treatment preferences were reported for minimally displaced lateral malleolus fractures seen on radiographs and were then compared with treatment preferences when computed tomography (CT) was added revealing a concomitant minimally displaced posterolateral fracture of the posterior malleolus. Results The cohort comprised 177 surgeons from all six continents. When radiographs showing a minimally displaced lateral malleolus fracture were presented, nonoperative management was indicated by 35 % (62) of participants, whereas 65 % (115) preferred operative intervention. After CT views were added showing an accompanying minimally displaced posterolateral posterior malleolus fracture, 79 % (140) suggested operative intervention and only 21 % (37) advocated nonoperative management (p =0.03). ConclusionsMost surgeons prefer open reduction with internal fixation for minimally displaced lateral malleolar fractures. The presence of concomitant posterior malleolus fractures in these cases shifts treatment preference further towards open reduction with internal fixation. Because the posterior malleolus fragment might not be well delineated on standard ankle radiographs, a high index of suspicion is warranted, and the use of CT should be considered in these cases.

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Adult ankle fractures—an increasing problem?

Cited by 568 publications

References 8 publications

A retrospective study of functional outcome of surgically managed malleolar fracture at the ankle joint by subjective, objective and radiological assessment

A retrospective study of functional outcome of surgically managed malleolar fracture at the ankle joint by subjective, objective and radiological assessment

Gendered Differences in Accidental Trauma to Upper and Lower Limb Bones at Aquincum, Roman Hungary

The effect of minimally displaced posterior malleolar fractures on decision making in minimally displaced lateral malleolus fractures

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