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. 2023 Jan 31;18(1):79.
doi: 10.1186/s13018-023-03558-2.

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

Emilia Möller Rydberg  1   2 , David Wennergren  3   4 , Caroline Stigevall  3   4 , Jan Ekelund  5 , Michael Möller  3   4
Affiliations

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

Emilia Möller Rydberg et al. J Orthop Surg Res. .

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.

Keywords: Ankle fracture; Epidemiology; Orthopaedic surgery; The Swedish Fracture Register.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The AO/OTA classification of ankle fractures. Illustration by Pontus Andersson/Pontus Art Production
Fig. 2
Fig. 2
Distribution between the sexes for ankle fractures by age group. Paediatric fractures and fractures that were registered as “not able to classify” are not included. Data shown for 1 April 2012 to 31 March 2022
Fig. 3
Fig. 3
Age and sex distribution of open ankle fractures. Data shown for 1 April 2012 to 31 March 2022
Fig. 4
Fig. 4
Gustilo–Andersson grade of open ankle fractures. Data shown for 1 April 2012 to 31 March 2022
Fig. 5
Fig. 5
Gustilo–Andersson grade of open ankle fractures in patients over the age of 65 years. Data shown for 1 April 2012 to 31 March 2022
Fig. 6
Fig. 6
Gustilo–Andersson grade of open ankle fractures in patients under the age of 65 years. Data shown for 1 April 2012 to 31 March 2022
Fig. 7
Fig. 7
Age and sex distribution of ankle fractures sustained in high-energy trauma. Data shown for 1 April 2012 to 31 March 2022
Fig. 8
Fig. 8
Seasonal variation in ankle fractures. Error bars: 95% CI
Fig. 9
Fig. 9
Seasonal variation in the number of ankle fractures according to mechanism of injury. Error bars: 95% CI
Fig. 10
Fig. 10
Seasonal variation in the number of ankle fractures for each fracture type, respectively. Error bars: 95% CI
See this image and copyright information in PMC

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