Gundtoft Per H, Pedersen Alma B, Viberg Bjarke
Orthopedic Department, Aarhus University Hospital; Department of Orthopedic Surgery, Kolding Hospital, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital; Department of Clinical Medicine, Aarhus University, Denmark.
Acta Orthop. 2025 Feb 27;96:203-208. doi: 10.2340/17453674.2025.43006.
Previous studies have shown large variation in the incidence of ankle fractures. Nationwide data covering longer periods is necessary to gain knowledge of the current trends. The aim of this study was to describe the trends in incidence, treatment, and mortality of ankle fracture during a 20-year period.
Ankle fractures in patients ≥ 18 years old were identified in the Danish National Patient Register using the validated diagnosis and surgical procedure codes for ankle fractures. Incidence rates per 100,000 and incidence rate ratio (IRR) are reported with 95% confidence intervals (CI).
We identified 155,740 ankle fractures. The overall mean incidence rate during the period 1997-2018 was 164 (CI 163-165) per 100,000 person-years, being 154 (CI 152-155) for men and 203 (CI 202-205) for women. The incidence rate increased from 155 (CI 131-179) during 1997-2006 to 173 (CI 147-199) during 2007-2018, corresponding to an IRR of 1.12 (CI 1.10-1.12). This increase was primarily driven by an increase in women, with an IRR of 1.21 (CI 1.20-1.23) and for patients above 50 years, with an IRR of 1.22 (CI 1.08-1.10). The proportion of patients surgically treated increased from 21% in 1997-2006 to 25% in 2007-2018. The 1-year mortality risk was higher for patients above 65 years with an ankle fracture compared with the general population of the same age, with an IRR of 1.47 (CI 1.42-1.53).
The incidence of ankle fracture increased from 1997 to 2018, primarily due to an increased incidence in women and in the elderly population. The proportion of surgically treated patients increased from 21% to 26%. Excess mortality after ankle fracture in patients above 65 years was observed.
既往研究表明踝关节骨折的发病率差异很大。需要覆盖更长时间段的全国性数据来了解当前趋势。本研究的目的是描述20年间踝关节骨折的发病率、治疗情况及死亡率的趋势。
利用经过验证的踝关节骨折诊断和手术操作编码，在丹麦国家患者登记处识别年龄≥18岁患者的踝关节骨折。报告每10万人的发病率及发病率比（IRR），并给出95%置信区间（CI）。
我们识别出155,740例踝关节骨折。1997 - 2018年期间的总体平均发病率为每10万人年164例（CI 163 - 165），男性为154例（CI 152 - 155），女性为203例（CI 202 - 205）。发病率从1997 - 2006年期间的155例（CI 131 - 179）增加到2007 - 2018年期间的173例（CI 147 - 199），对应的发病率比为1.12（CI 1.10 - 1.12）。这种增加主要由女性发病率的增加驱动，发病率比为1.21（CI 1.20 - 1.23），50岁以上患者的发病率比为1.22（CI 1.08 - 1.10）。接受手术治疗的患者比例从1997 - 2006年的21%增加到2007 - 2018年的25%。与同年龄的普通人群相比，65岁以上踝关节骨折患者的1年死亡风险更高，发病率比为1.47（CI 1.42 - 1.53）。
1997年至2018年踝关节骨折的发病率增加，主要原因是女性和老年人群发病率上升。接受手术治疗的患者比例从21%增加到26%。观察到65岁以上患者踝关节骨折后存在超额死亡率。
