The Epidemiology of Fractures Caused by Falls Down Stairs

Fractures sustained from a fall down stairs have received little attention in the orthopaedic literature. We have undertaken a study of these fractures to determine their epidemiology and to compare it to that of fractures caused by a standing fall. All new patients presenting with a fracture between July 2007 and June 2008 were prospectively identified. Falls down stairs caused 261 fractures and were the fifth commonest mode of injury in all ages but the second commonest in those aged 65 years or over. Patients in this category were significantly younger than those with a fracture from a standing fall (54.6 yrs versus 64.9 yrs, P<0.001). Fractures of the ankle (odds ratio (OR) 1.9, P<0.001), talus (OR 3.0, P=0.04), calcaneus (OR 9.7, P<0.001), midfoot (OR 6.9, P<0.001), toe phalanges (OR 12.0, P<0.001), scapula (OR 4.6, P=0.002), and proximal ulna (OR 2.4, P=0.04) were significantly more likely to result from a fall involving stairs. When grouped together, the odds of any foot or ankle fracture resulting from a fall down stairs were approximately double when compared with a fall from standing (OR 2.1, P<0.001). There was a trend towards increased fracture incidence from falls down stairs with worsening social deprivation (r=0.63, P=0.05). A fall down stairs poses a substantial risk of fractures of the foot, ankle, and scapula. When examining patients with this mechanism of injury, these fracture types should be excluded.

Download Full-text

Does the Covid-19 pandemic affect ankle fracture incidence? Moderate decrease in Sweden

Acta Orthopaedica ◽

10.1080/17453674.2021.1907517 ◽

2021 ◽

pp. 1-4

Author(s):

Emilia Möller Rydberg ◽

Michael Möller ◽

Jan Ekelund ◽

Olof Wolf ◽

David Wennergren

Keyword(s):

Ankle Fracture ◽

Fracture Incidence

Download Full-text

Stability-based classification for ankle fracture management and the syndesmosis injury in ankle fractures due to a supination external rotation mechanism of injury

Acta Orthopaedica ◽

10.3109/17453674.2012.745657 ◽

2012 ◽

Vol 83 (sup347) ◽

pp. 1-31 ◽

Cited By ~ 19

Author(s):

Harri Pakarinen

Keyword(s):

Ankle Fracture ◽

External Rotation ◽

Ankle Fractures ◽

Mechanism Of Injury ◽

Syndesmosis Injury ◽

Fracture Management ◽

Supination External Rotation

Download Full-text

Fractures of the proximal ulna: current concepts in surgical management

EFORT Open Reviews ◽

10.1302/2058-5241.4.180022 ◽

2019 ◽

Vol 4 (1) ◽

pp. 1-9 ◽

Cited By ~ 7

Author(s):

Sebastian Siebenlist ◽

Arne Buchholz ◽

Karl F. Braun

Keyword(s):

Radial Head ◽

Injury Severity ◽

Joint Stiffness ◽

Coronoid Process ◽

Collateral Ligament ◽

Postoperative Rehabilitation ◽

Proximal Ulna ◽

Elbow Function ◽

Fracture Types ◽

Olecranon Fractures

Fractures of the proximal ulna range from simple olecranon fractures to complex Monteggia fractures or Monteggia-like lesions involving damage to stabilizing key structures of the elbow (i.e. coronoid process, radial head, collateral ligament complex). In complex fracture patterns a computerized tomography scan is essential to properly assess the injury severity. Exact preoperative planning for the surgical approach is vital to adequately address all fracture parts (base coronoid fragments first). The management of olecranon fractures primarily comprises tension-band wiring in simple fractures as a valid treatment option, but modern plate techniques, especially in comminuted or osteoporotic fracture types, can reduce implant failure and potential implant-related soft tissue irritation. For Monteggia injuries, the accurate anatomical restoration of ulnar alignment and dimensions is crucial to adjust the radiocapitellar joint. Caution is advised if the anteromedial facet (anatomical insertion of the medial collateral ligament) of the coronoid process is affected, to avoid posteromedial instability. Radial head reconstruction or replacement is essential in Monteggia-like lesions to restore normal elbow function. The postoperative rehabilitation programme should involve active elbow motion exercises without limitations as early as possible following surgery to avoid joint stiffness. Cite this article: EFORT Open Rev 2019;4:1-9. DOI: 10.1302/2058-5241.4.180022.

Download Full-text

Foot and Ankle Fracture Incidence in South-Eastern Australia: An Epidemiological Study

Clinical Research on Foot & Ankle ◽

10.4172/2329-910x.1000148 ◽

2014 ◽

Vol 02 (04) ◽

Cited By ~ 5

Author(s):

Kara L Holloway

Keyword(s):

Epidemiological Study ◽

Ankle Fracture ◽

Fracture Incidence ◽

Foot And Ankle ◽

South Eastern ◽

Eastern Australia ◽

South Eastern Australia

Download Full-text

The epidemiology of fractures of the hand and the influence of social deprivation

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193410381823 ◽

2010 ◽

Vol 36 (1) ◽

pp. 62-65 ◽

Cited By ~ 30

Author(s):

R. E. Anakwe ◽

S. A. Aitken ◽

J. G. Cowie ◽

S. D. Middleton ◽

C. M. Court-Brown

Keyword(s):

Operative Treatment ◽

Social Deprivation ◽

Mechanism Of Injury ◽

Trauma Unit ◽

Hand Fractures ◽

Hand Fracture ◽

To Receive ◽

The Relationship ◽

Gender Specific ◽

Little Finger

This study investigates the relationship between the epidemiology of hand fractures and social deprivation. Data were collected prospectively in a single trauma unit serving a well-defined population. The 1382 patients treated for 1569 fractures of the metacarpals or phalanges represented an incidence of hand fracture of 3.7 per 1000 per year for men and 1.3 per 1000 per year for women. Deprivation was not directly associated with the incidence of hand fracture. Common mechanisms of injury are gender specific. Fractures of the little finger metacarpal were common (27% of the total) and were associated with social deprivation in men ( P = 0.017). For women, fractures where the mechanism of injury was unclear or the patient was intoxicated and could not recall the mechanism showed a clear association with deprivation. Affluent patients were more likely to receive operative treatment. Social deprivation influences both the pattern and management of hand fractures.

Download Full-text

Risk Factors for Prolonged Opioid Use After Ankle Fracture Surgery

Foot & Ankle Specialist ◽

10.1177/19386400211029123 ◽

2021 ◽

pp. 193864002110291

Author(s):

Matthew S. Broggi ◽

Philip O. Oladeji ◽

Corey Spenser ◽

Rishin J. Kadakia ◽

Jason T. Bariteau

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Odds Ratio ◽

Ankle Fracture ◽

Significant Risk ◽

Patient Characteristics ◽

Low Back ◽

Opioid Use ◽

Increased Risk ◽

Fracture Surgery

Background The incidence of ankle fractures is increasing, and risk factors for prolonged opioid use after ankle fracture fixation are unknown. Accordingly, the purpose of this study was to investigate risk factors that lead to prolonged opioid use after surgery. Methods The Truven MarketScan database was used to identify patients who underwent ankle fracture surgery from January 2009 to December 2018 based on CPT codes. Patient characteristics were collected, and patients separated into 3 cohorts based on postoperative opioid use (no refills, refills within 6 months postoperative, and refills within 1 year postoperatively). The χ2 test and multivariate analysis were performed to assess the association between risk factors and prolonged use. Results In total, 34 691 patients were analyzed. Comorbidities most highly associated with prolonged opioid use include 2+ preoperative opioid prescriptions (odds ratio [OR] = 11.92; P < .001), tobacco use (OR = 2.03; P < .001), low back pain (OR = 1.81; P < .001), depression (OR = 1.48; P < .001), diabetes (OR = 1.34; P < .001), and alcohol abuse (OR = 1.32; P < .001). Conclusion Opioid use after ankle fracture surgery is common and may be necessary; however, prolonged opioid use and development of dependence carries significant risk. Identifying those patients at an increased risk for prolonged opioid use can aid providers in tailoring their postoperative pain regimen. Levels of Evidence Prognostic, Level III

Download Full-text

Hip fracture incidence and social deprivation: results from a French ecological study

Osteoporosis International ◽

10.1007/s00198-017-3998-z ◽

2017 ◽

Vol 28 (7) ◽

pp. 2045-2051 ◽

Cited By ~ 7

Author(s):

M .-P. Petit ◽

J. Bryère ◽

M. Maravic ◽

F. Pallaro ◽

C. Marcelli

Keyword(s):

Hip Fracture ◽

Ecological Study ◽

Social Deprivation ◽

Fracture Incidence ◽

Hip Fracture Incidence

Download Full-text

Inequalities in hip fracture incidence are greatest in the North of England: regional analysis of the effects of social deprivation on hip fracture incidence across England

Public Health ◽

10.1016/j.puhe.2018.05.002 ◽

2018 ◽

Vol 162 ◽

pp. 25-31 ◽

Cited By ~ 6

Author(s):

A. Bhimjiyani ◽

J. Neuburger ◽

T. Jones ◽

Y. Ben-Shlomo ◽

C.L. Gregson

Keyword(s):

Hip Fracture ◽

Social Deprivation ◽

Regional Analysis ◽

Fracture Incidence ◽

The North ◽

Hip Fracture Incidence

Download Full-text

Incidence of Chondral Lesions of Talar Dome in Ankle Fracture Types

Foot & Ankle International ◽

10.3113/fai.2008.0287 ◽

2008 ◽

Vol 29 (3) ◽

pp. 287-292 ◽

Cited By ~ 60

Author(s):

Seref Aktas ◽

Baris Kocaoglu ◽

Arel Gereli ◽

Ufuk Nalbantodlu ◽

Osman Güven

Keyword(s):

Ankle Fracture ◽

Fracture Repair ◽

Ankle Fractures ◽

Talar Dome ◽

Distal Fibula ◽

Chondral Lesions ◽

Anatomic Reduction ◽

Arthroscopically Assisted ◽

Male Patients ◽

Fracture Types

Background: Although the surgical treatment of ankle fractures is well known, a paucity of literature exists correlating chondral lesions with ankle fracture types. Materials and Methods: This study is a retrospective review of patients with absence or presence of chondral lesions that underwent arthroscopically assisted open reduction and internal fixation between June 2002 and April 2005. There were 38 female and 48 male patients (mean age, 41.4 years; mean followup, 33.9 months), and all had an Ankle-Hindfoot Scale score. The relationship between fracture types and presence of lesions was evaluated. Results: Four of 27 fractures with chondral lesions consisted of the bimalleolar type, 6 of 15 fractures with chondral lesions consisted of the trimalleolar type, and 14 of 20 distal fibula fractures had chondral lesions. There was significant greater incidence of chondral lesions associated with distal fibula fractures. The mean AOFAS score was 95.6 among all fractures. Conclusion: There is clear evidence that despite anatomic reduction, postoperative results of ankle fracture repair are not free of complications. We believe inspection of the talar dome should be routinely considered in the surgical repair ankle fractures.

Download Full-text