Epidemiology of more than 50,000 ankle fractures in the Swedish Fracture Register during a period of 10 years

Abstract Background Despite being one of the most common types of fracture, there is a lack of epidemiological studies involving ankle fractures of all kinds. Since 2012, the Swedish Fracture Register (SFR) has prospectively collected data on surgically and non-surgically treated ankle fractures. The aim of this study is to describe the epidemiology of ankle fractures between 2012 and 2022. Methods All ankle fractures registered in the SFR between 1 April 2012 and 31 March 2022 in patients aged 16 years or older were included. Information on age, sex, mechanism of injury, fracture classification according to AO/OTA and high- or low-energy trauma was retrieved from the SFR. Results During the study period, 56,439 patients sustained 57,443 ankle fractures. Women (61%) were more commonly affected than men (39%). The mean age at the time of injury was 55 years. Men were found to be younger at the time of injury compared with women. Women were found to sustain open fractures more frequently, whereas the men more frequently sustained high-energy trauma. The most common mechanism of injury for all ankle fractures and for each AO/OTA44 fracture group separately was a simple fall. A seasonal variation in ankle fractures was found, where the number of ankle fractures peaked during the between November and March. Conclusions This study presents the epidemiology of all AO/OTA types of ankle fractures. We have demonstrated that most ankle fractures are caused by a simple fall and occur during wintertime. Women are more commonly affected than men and are older at the time of injury. These findings indicate that age-related skeletal fragility, as well as an increasing risk of simple falls in the elderly, may be risk factors for ankle fractures. This study will contribute to the planning of primary prevention for ankle fractures.