Epidemiology of more than 50,000 ankle fractures in the Swedish Fracture Register during a period of 10 years

Abstract

Background Despite being one of the most common types of fracture, there is a lack of epidemiological studies involving ankle fractures of all kinds. Since 2012, the Swedish Fracture Register (SFR) has prospectively collected data on surgically and non-surgically treated ankle fractures. The aim of this study is to describe the epidemiology of ankle fractures between 2012 and 2022. Methods All ankle fractures registered in the SFR between 1 April 2012 and 31 March 2022 in patients aged 16 years or older were included. Information on age, sex, mechanism of injury, fracture classification according to AO/OTA and high- or low-energy trauma was retrieved from the SFR. Results During the study period, 56,439 patients sustained 57,443 ankle fractures. Women (61%) were more commonly affected than men (39%). The mean age at the time of injury was 55 years. Men were found to be younger at the time of injury compared with women. Women were found to sustain open fractures more frequently, whereas the men more frequently sustained high-energy trauma. The most common mechanism of injury for all ankle fractures and for each AO/OTA44 fracture group separately was a simple fall. A seasonal variation in ankle fractures was found, where the number of ankle fractures peaked during the between November and March. Conclusions This study presents the epidemiology of all AO/OTA types of ankle fractures. We have demonstrated that most ankle fractures are caused by a simple fall and occur during wintertime. Women are more commonly affected than men and are older at the time of injury. These findings indicate that age-related skeletal fragility, as well as an increasing risk of simple falls in the elderly, may be risk factors for ankle fractures. This study will contribute to the planning of primary prevention for ankle fractures.

Patients with more complex ankle fractures are associated with poorer patient-reported outcome: an observational study of 11,733 patients from the Swedish Fracture Register

“…This may correspond to the relatively high reported impairment in PROMs in these groups. Another factor negatively affecting PROMs is the higher incidence of high-energy trauma and open fractures seen in younger patients [ 18 ]. Our study demonstrates that both open injuries and high-energy trauma had a statistically significant negative effect on outcome, and even more so when combined.…”

“…This would lead to a higher degree of instability and thereby a more severe injury. However, Rydberg et al demonstrated that patients with C2 fractures had the lowest mean age among all ankle fracture types and C2 was also the fracture type with the largest proportion of open fractures [ 18 ]. This could be one explanation as to why C2 fractures in this study had a greater impairment in PROMs than C3 fractures, because open fractures had a major negative effect on PROMs.…”

Analysis of the Most Popular Online Ankle Fracture–Related Patient Education Materials

“…Ankle fractures are one of the most common types of fracture, most commonly occurring in the winter time secondary to falls or sports-related injuries. 27 Although the average age of patients with ankle fractures varies depending on patient sex, incidence typically peaks earlier between 10 and 25 years of age for male patients and later between 70 and 80 years of age for female patients. 27 , 28 , 35 The present study found that the most popular online PEMs regarding ankle fracture are of acceptable quality and meet the NIH recommendation of being written at an eighth-grade reading level.…”

“… 27 Although the average age of patients with ankle fractures varies depending on patient sex, incidence typically peaks earlier between 10 and 25 years of age for male patients and later between 70 and 80 years of age for female patients. 27 , 28 , 35 The present study found that the most popular online PEMs regarding ankle fracture are of acceptable quality and meet the NIH recommendation of being written at an eighth-grade reading level. The articles evaluated in this study demonstrated an average quality score of 15.07 with an average FKGL of 8.38.…”

Gait Analysis to Monitor Fracture Healing of the Lower Leg

“…The incidence of tibial fractures in Sweden was 52 per 100,000 per year, with proximal tibial fractures (Figure 1) being the most common tibial fractures, followed by tibial shaft and distal tibial fractures, respectively 26.9, 15.7, and 9.1 per 100,000 per year [1]. The incidence of malleolar fractures in Sweden was 152 per 100,000 per year [2]. In some cases, non-displaced fractures are treated conservatively by immobilization using a cast or brace [3].…”