Epidemiology of Adult Ankle Fractures: 1756 cases identified in Norrbotten County during 2009–2013 and classified according to AO/OTA

Abstract

BackgroundThe ankle fracture is one of the most common fractures, increasing in an ageing population, but not generally seen as an osteoporotic fracture. The aim of this study was to examine the relationship between different AO/OTA classes of ankle fractures, age, sex and type of trauma.MethodsAnkle fractures, treated at any of the hospitals in Norrbotten County in Sweden between 2009 and 2013, were retrospectively identified and classified according to the AO/OTA-classification system. Information about the trauma mechanism was also obtained.ResultsIn Norrbotten County, 1756 ankle fractures in 1735 patients aged 20 years or older were identified. This gave an incidence in the county of 179 per 100,000 person-years. Of these patients, 34.6% were 65 years or older, 58.4% were women and 68.2% of the trauma leading to a fracture was defined as low-energy. In 1.5% of the cases the fractures were open. Incidences of type B fractures increased substantially with age, from 62 (95% CI 50–77) at 30–39 years of age to 158 (95% CI 131–190) in patients older than 80 years of age per 100,000 person-years. Type B fractures showed a slightly higher proportion of low-energy trauma while type C showed a lower mean age and proportion of women.ConclusionsThis study shows an incidence of 179 adult ankle fractures annually per 100,000 persons. More than two thirds of the fractures were caused by a low-energy trauma and ankle fractures are more frequent among females. Females generally have an increased incidence during their life, mainly between the ages of 30 and 60. This is in contrast to men who have more of an even distribution throughout their life. Classification according to AO/OTA reveals some heterogeneity among the classes of ankle fractures in age and gender as well as the energy involved in the trauma.

Reporting Discrepancy Resolved by Findings and Time in 2947 Emergency Department Ankle X-rays

“…This study found a distribution of ankle X-ray findings consistent with that seen in existing data, with isolated malleolar fractures and specifically Weber type B lateral malleolar fractures representing the most common injuries [10,11].…”

“…The overall results of this study support earlier findings that fractures of the lateral malleolus represent the most common ankle fractures, with the highest incidence being of Weber type B, followed by type A and then C [10]. There is also strong evidence to support the finding that isolated malleolar injuries make up the majority of ankle fractures, with relatively lower proportions of bimalleolar and trimalleolar fractures [10,11].…”

The new ultralow dose CT protocol for the diagnosis of fractures of the ankle: A prospective comparative study with conventional CT

“…15 ULDCT (mean ULDCT dose 0.47+ 0.02 mSv) protocol can provide satisfactory diagnostic data with less doses of radiation than multiple X-ray views. 15,18 In a recent critical review, Rammelt and Boszczyk recommended the use of CT imaging in malleolar fractures with unstable syndesmosis, fractures of the posterior malleolus, supination adduction type fractures with medial plafond impaction, spiral fractures of the distal tibia, and transitional ankle fractures in adolescents. 6 Alagic et al compared digital radiography with ULDCT imaging in 207 extremities.…”

Is there a safe place for posterior malleolar screw fixation? An anatomic study on dry bones

“…Ankle fractures with posterior malleolar (PM) involvement are not uncommon and have been reported up to 44%. [ 1 - 4 ] It is generally accepted that a PM fracture involving the one-quarter to one-third of the distal tibial articular surface and displacement of more than 2 mm necessitates surgical fixation. [ 5 ] However, recent clinical and experimental studies have shown that the fixation of the PM fracture regardless of its size provides significant stability to the ankle.…”