Abstract
Ankle fractures are a common traumatic lower extremity injury and are generally classified
and characterized by the rotational mechanism of injury. At each malleolus (i.e.,
posterior, medial, and lateral) a fracture can occur or a ligamentous injury may be
sustained. The purpose of this retrospective study was to determine if bone mineral
density is a contributing factor on the number of fractured malleoli versus soft tissue
injury in adult ankle fractures. Data was obtained from a registry of ankle fractures
that were operatively treated by the foot and ankle team throughout our institutional
facilities, from July 2017 to August 2019, and in which a preoperative computerized
tomography scan was performed. Regional bone mineral density (BMD) was measured by
calculating the average Hounsfield Unit (HU) on axial computerized tomography images
of the distal fibula and tibia. The average HU was then compared to the number of
fractured malleoli. One hundred eight patients met the study criteria. We identified
statistically significant relationships between decreased BMD with increasing age
(p < .01) and the male gender (p < .01). After adjusting for the covariates age and gender, no statistically significant
relationship was identified between BMD and the number of malleoli involved in a given
ankle fracture (p = .11). These findings suggest that while more investigation is required for ankle
fracture patterns and BMD evaluation, increased age and biologic female gender is
significantly related to decreased BMD as identified via HU.
Keywords
Level of Clinical Evidence
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Article info
Publication history
Published online: August 31, 2022
Publication stage
In Press Corrected ProofFootnotes
Financial Disclosure: The authors have nothing to disclose with regards to this manuscript. COI forms are attached.
Conflict of Interest: None reported.
Identification
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© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
