Children's ankle fractures. Classification and epidemiology.

Area of Science:

• Orthopedics
• Pediatric Traumatology
• Radiology

Background:

• Childhood and adolescent fractures represent a significant public health concern.
• Ankle fractures are common injuries in pediatric populations, requiring detailed epidemiological analysis.
• Understanding fracture patterns and incidence trends is crucial for prevention and treatment strategies.

Purpose of the Study:

• To investigate the incidence, types, and etiological factors of childhood and adolescent fractures in Malmö over a 30-year period.
• To classify ankle fractures based on roentgenological appearance and analyze their frequency.
• To examine sex and age-related differences, seasonal variations, and trends in fracture incidence.

Main Methods:

• Retrospective analysis of 8,682 fractures in children aged 0-16 years from Malmö, spanning 1950 to 1975-79.
• Classification of 373 ankle fractures based on roentgenological appearance.
• Statistical analysis to assess differences between sexes, age groups, and time periods, and to identify etiological factors and seasonal variations.

Main Results:

• Avulsion fractures of the lateral malleolus and distal fibular physis fractures were the most common ankle fractures.
• Triplane and Tillaux fractures were also frequent, with Tillaux fractures being more prevalent in girls.
• Most fractures resulted from low-energy trauma, with bicycle-related foot entrapment being a specific cause for lateral malleolus epiphyseal fractures.
• A seasonal variation was observed, with higher incidence in spring and autumn.
• Fracture incidence increased with age until early teens and showed a significant increase over the 30-year study period.

Conclusions:

• Ankle fractures in children and adolescents exhibit specific patterns, with avulsion and physeal fractures being predominant.
• Low-energy trauma is the primary cause, highlighting the need for injury prevention measures.
• The increasing incidence over time suggests a potential rise in pediatric fracture risk, warranting further investigation.