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Scheer RC, Newman JM, Zhou JJ, Oommen AJ, Naziri Q, Shah NV, Pascal SC, Penny GS, McKean JM, Tsai J, Uribe JA. Ankle Fracture Epidemiology in the United States: Patient-Related Trends and Mechanisms of Injury. J Foot Ankle Surg 2021; 59:479-483. [PMID: 32354504 DOI: 10.1053/j.jfas.2019.09.016] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 09/11/2019] [Indexed: 02/03/2023]
Abstract
Current nationwide epidemiological data regarding ankle fractures are scarce. Such information is important towards better quantifying the mortality associated with such injuries, financial impact, as well as the implementation of preventative measures. This study evaluated the epidemiology of ankle fractures that occurred during a 5-year period. Specifically, we evaluated demographics, mechanism of injury, and disposition. The National Electronic Injury Surveillance System was queried to identify all patients with ankle fractures that presented to US hospital emergency departments between 2012 and 2016. Census data were used to determine the incidence rates of ankle fractures in terms of age, sex, and race. There was an estimated total of 673,214 ankle fractures that occurred during this period, with an incidence rate of 4.22/10,000 person-years. The mean age of patients with an ankle fracture was 37 ± 22.86 (SD) years; 23.5% of ankle fractures occurred in patients aged 10 to 19 years (7.56/10,000 person-years). In addition, 44% of ankle fractures occurred in men (3.81/10,000 person-years), whereas 56% occurred in women (4.63/10,000 person-years). Data on race/ethnicity were available for 71% of the subjects, with incidence rates of 2.85/10,000 person-years for whites, 3.01/10,000 person-years for blacks, and 4.08/10,000 person-years for others. The most common mechanism of injury was falls (54.83%), followed by sports (20.76%), exercise (16.84%), jumping (4.42%), trauma (2.84%), and other (0.30%). For disposition, 81.84% of patients were treated and released, 1.43% were transferred, 16.01% were admitted, 0.59% were held for observation, and 0.13% left against medical advice. The highest incidence of ankle fractures in men occurred in the 10-to-19-years age group, but women were more commonly affected in all other age groups.
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Affiliation(s)
- Ryan C Scheer
- Medical Student, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Jared M Newman
- Orthopaedic Surgery Resident, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY.
| | - Jack J Zhou
- Medical Student, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Alvin J Oommen
- Medical Student, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Qais Naziri
- Orthopaedic Surgeon, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY; Orthopaedic Surgeon, Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL
| | - Neil V Shah
- Orthopaedic Surgery Resident, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Scott C Pascal
- Orthopaedic Surgery Resident, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Gregory S Penny
- Orthopaedic Surgery Resident, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Jason M McKean
- Orthopaedic Surgeon, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY; Orthopaedic Surgeon, Department of Orthopaedic Surgery, Brookdale University Hospital Medical Center, Brooklyn, NY
| | - Justin Tsai
- Orthopaedic Surgeon, Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, New York, NY
| | - Jaime A Uribe
- Assistant Professor of Orthopaedic Surgery, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
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Ross AJ, Little J, Seligson D. Limb salvage of ankle fracture dislocation with LIMA external fixator: a case report. Foot Ankle Spec 2013; 6:50-3. [PMID: 23074295 DOI: 10.1177/1938640012463058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Open ankle fractures with dislocation are potentially limb-threatening injuries with complications ranging from infection to amputation. External fixation has been used in trauma institutions for limb salvage, particularly in the setting of extensive soft tissue compromise. The authors present a case of an elderly woman with an open ankle fracture dislocation who underwent a staged surgical approach. A LIMA external fixator was used in conjunction with antibiotic beads and subsequent definitive open reduction with internal fixation. At 5-year follow-up, the patient demonstrated pain-free range of motion with a return to activity comparable to the preinjury state. The authors highlight the benefit of procedure staging in the presence of a severe fracture dislocation of the tibiotalar joint.
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Affiliation(s)
- Adrianne JinLing Ross
- Department of Orthopedic Surgery, University of Louisville Medical Center, Louisville, Kentucky, USA.
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King CM, Hamilton GA, Cobb M, Carpenter D, Ford LA. Association between ankle fractures and obesity. J Foot Ankle Surg 2012; 51:543-7. [PMID: 22789485 DOI: 10.1053/j.jfas.2012.05.016] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2010] [Indexed: 02/07/2023]
Abstract
Obesity is an epidemic in the United States and is associated with an increased risk of musculoskeletal problems. Rotational injuries of the ankle with a Weber C fibula fracture have a greater risk of syndesmosis disruption and instability. The goal of the present study was to explore the association between obesity and ankle fractures. Using a retrospective review, the radiographs of 280 patients with an ankle fracture were reviewed and classified using the Weber classification, which was then associated with the body mass index, gender, age, diabetes, tobacco use, and osteoporosis. Patients with a body mass index of 30 kg/m(2) or greater (odds ratio 1.78), men (odds ratio 1.74), and age 25 years or younger (odds ratio 3.97) had greater odds of having a Weber C ankle fracture (compared with Weber A and B) and Weber C and B (compared with Weber A). Diabetes mellitus, osteoporosis/osteopenia, and current tobacco use were not significantly associated with the severity of the ankle fracture. The results from the present study suggest that obesity presents a greater risk of sustaining a more proximal distal fibula fracture.
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Affiliation(s)
- Christy M King
- Kaiser San Francisco Bay Area Foot and Ankle Residency Program, Oakland, CA 94611, USA.
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Abstract
Ankle fractures are important injuries involving a weight-bearing joint critical to mobility. This article will discuss the necessity of and justification for surgical correction of virtually all ankle fractures. Various ankle fracture types will be explored, mechanisms illuminated and proper treatment outlined for these complex injuries.
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Affiliation(s)
- Denise M Mandi
- Section of Foot & Ankle Surgery, Department of Surgery, Broadlawns Medical Center, 1801 Hickman Road, Des Moines, IA 50314, USA.
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