Open ankle fractures: who gets them and why?

Area of Science:

• Orthopaedic Surgery
• Trauma Epidemiology
• Geriatric Trauma

Background:

• Open ankle fractures are a significant clinical challenge with extensive literature on management and outcomes.
• Epidemiological data and trends for open ankle fractures have not been previously reported.

Purpose of the Study:

• To investigate the epidemiology of open ankle fractures over a 23-year period.
• To identify changes in incidence, patient demographics, injury mechanisms, and associated factors over time.

Main Methods:

• Retrospective analysis of 178 adult patients with open ankle fractures over 23 years.
• Data collected from a single regional trauma center with a defined population.
• Statistical analysis to assess trends in age, incidence, and injury mechanisms.

Main Results:

• The incidence of open ankle fractures was 1.5/10^5/year, comprising 1.5% of all ankle fractures.
• Mean patient age increased significantly from 44 to 64 years over the study period.
• Simple falls were the most common mechanism (74%), with a higher proportion of motor vehicle collisions in more deprived groups.

Conclusions:

• Open ankle fractures are increasingly presenting as low-energy insufficiency fractures in the elderly, particularly women.
• This epidemiological shift necessitates adjustments in healthcare service planning, training, and surgical approaches for this patient demographic.