Vieira Cardoso Diogo, Dubois-Ferrière Victor, Gamulin Axel, Baréa Christophe, Rodriguez Pablo, Hannouche Didier, Lübbeke Anne
Department of Orthopaedic Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
BMC Musculoskelet Disord. 2021 Mar 11;22(1):266. doi: 10.1186/s12891-021-04144-5.
Ankle fractures are common, and their incidence has been increasing. Previous epidemiological studies have been conducted in the US, Scandinavia, and Scotland. Our objectives were to provide a current epidemiological overview of operatively treated ankle fractures and to evaluate the influence of age, sex, lifestyle factors, and comorbidities on fracture types.
We performed a population-based epidemiological study of all ankle fractures treated operatively in a 10- year period from 2002 to 2012.
Two thousand forty-five ankle fractures were operated upon. Men and women differed significantly in age (median 41 vs. 57 years old), obesity (16% vs. 23%), diabetes (5% vs. 10%), smoking (45% vs. 24%), and accident type (daily activities 48% vs. 79%, transportation 24% vs. 9%, sports 21% vs. 8%) respectively. Overall, there were 2% Weber A, 77% Weber B, and 21% Weber C fractures; 54% were uni-, 25% bi-, and 21% trimalleolar; 7.5% of all fractures were open. Weber C fractures were much more frequent among men and with higher BMI (lowest vs. highest category: 14% vs. 32%), but slightly less frequent with older age and among current smokers. Trimalleolar fractures were twice as frequent in women and increased with age.
Men and women differed substantially in age, lifestyle factors, comorbidities, accident type, and type of ankle fracture. Male sex and higher BMI were more frequently associated with Weber C fractures, whereas female sex and older age were associated with trimalleolar fracture. The risk for severe fracture increased linearly with the degree of obesity.
踝关节骨折很常见，且其发病率一直在上升。此前的流行病学研究在美国、斯堪的纳维亚半岛以及苏格兰开展。我们的目标是提供接受手术治疗的踝关节骨折的当前流行病学概况，并评估年龄、性别、生活方式因素及合并症对骨折类型的影响。
我们对2002年至2012年这10年间所有接受手术治疗的踝关节骨折进行了一项基于人群的流行病学研究。
共对2045例踝关节骨折进行了手术。男性和女性在年龄（中位数分别为41岁和57岁）、肥胖（16%对23%）、糖尿病（5%对10%）、吸烟（45%对24%）以及事故类型（日常活动48%对79%、交通24%对9%、运动21%对8%）方面存在显著差异。总体而言，Weber A型骨折占2%，Weber B型骨折占77%，Weber C型骨折占21%；单踝骨折占54%，双踝骨折占25%，三踝骨折占21%；所有骨折中7.5%为开放性骨折。Weber C型骨折在男性中更为常见，且体重指数较高（最低类别对最高类别：14%对32%），但在年龄较大者和当前吸烟者中略少。三踝骨折在女性中发生率是男性的两倍，且随年龄增加而增多。
男性和女性在年龄、生活方式因素、合并症、事故类型以及踝关节骨折类型方面存在很大差异。男性和较高的体重指数与Weber C型骨折更常相关，而女性和较高年龄与三踝骨折相关。严重骨折的风险随肥胖程度呈线性增加。
