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.
Level of Clinical Evidence
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of Foot and Ankle SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Epidemiology of ankle fractures: a prospective population-based study of 212 cases in Aalborg, Denmark.Acta Orthop Scand. 1998; 69: 48-50
- Ankle fractures.Clin Podiatr Med Surg. 2006; 23: 375-422
- Understanding risks and complications in the management of ankle fractures.Indian J Orthop. 2014; 48: 445-452
Hsu RY, Lee Y, Hayda R, Digiovanni CW, Mor V, Bariteau JT. Morbidity and mortality associated with geriatric ankle fractures: a Medicare Part A claims database analysis. J Bone Joint Surg Am2015;97:1748–1755.
- Ankle fractures: review article.J Arthritis. 2015; 5: 1-4
- Complications in ankle fracture surgery.Acta Orthop. 2015; 86: 1-35
- Patient-based and surgical risk factors for 30-day postoperative complications and mortality after ankle fracture fixation.J Orthop Trauma. 2015; 29: e476-e482
- The costs of operative complications for ankle fractures: a case control study.Adv Orthop. 2014; 2014709241
- The salvage of open grade IIIB ankle and talus fractures.J Orthop Trauma. 1992; 6: 201-208
- National Health Expenditure Projections 2016-2025.(Available from:)https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/proj2016.pdfDate: 2017Date accessed: July 10, 2018
- Economic burden of foot and ankle surgery in the US Medicare population.Foot Ankle Int. 2014; 35: 334-340
- Cost description of inpatient treatment for ankle fracture.Injury. 2011; 42: 1226-1229
- Is early operative fixation of unstable ankle fractures cost effective? Comparison of the cost of early versus late surgery.Eur J Orthop Surg Traumatol. 2013; 23: 835-837
- Epidemiology of ankle fractures in Rochester, Minnesota.Acta Orthop. 1987; 58: 539-544
- Increased mortality after lower extremity fractures in patients <65 years of age.Acta Orthop. 2016; 87
- Overuse injuries in the IDF's combat training units: rates, types, and mechanisms of injury.Mil Med. 2018; 183: e196-e200
- Epidemiology and impact on performance of lower extremity stress injuries in professional basketball players.Sports Health. 2018; 10: 169-174
- US Consumer Product Safety Commission.2000 (Accessed July 10, 2017. n.d)
NEISS - The National Electronic Injury Surveillance System A Tool for Researchers. Div Hazard Inj Data Syst US Consum Prod Saf Comm 2000:1–38.
- The NEISS sample (design and implementation) 1997 to Present.Washington, DC, US Consumer Product Safety Commission2001 (n.d)
- Epidemiology of foot and ankle fractures in the United States: an analysis of the National Trauma Data Bank (2007 to 2011).J Foot Ankle Surg. 2014; 53: 606-608
- Hospital remoteness and thirty-day mortality from three serious conditions.Health Aff. 2008; 27: 1707-1717
- Rural populations and their health.Rural Heal. Serv. A Manag. Perspect. 1994; : 3-26
- Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008.Arthritis Care Res. 2012; 64: 407-414
- Incidence and epidemiology of patellar fractures.Orthopedics. 2016; 39: e1154-e1158
- A prospective, randomized study of the management of severe ankle fractures.J Bone Joint Surg Am. 1985; 67: 12
- Epidemiology of adult fractures: A review.Injury. 2006; 37: 691-697
- Population-based epidemiology of 9767 ankle fractures.Foot Ankle Surg. 2016;
- Major osteoporotic fragility fractures: risk factor updates and societal impact.World J Orthop. 2016; 7: 171
- Epidemiology of fracture risk with advancing age.J Gerontol Ser A Biol Sci Med Sci. 2013; 68: 1236-1242
- The effect of age on fracture risk: a population-based cohort study.J Aging Res. 2016; (2016)
- The assessment of fracture risk.J Bone Joint Surg Am. 2010; 92: 743
- Assessment of fracture risk.Osteoporos Int. 2005; 16: 581-589
Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2019 by the American College of Foot and Ankle Surgeons. All rights reserved.
