Nationwide incidence of lateral malleolar fracture surgery across 6 European countries: has recent evidence changed clinical practice?
Background and purpose — Increased use of weightbearing radiographs to assess ankle mortise stability have suggested that most lateral malleolar fractures with a congruent mortise on initial radiographs can successfully be treated nonoperatively. We aimed to evaluate trends in the surgical managemen...
| Published in: | Acta Orthopaedica Vol. 96; pp. 763 - 771 |
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| Main Authors: | , , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Medical Journals Sweden AB
2025
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191461435&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 191461435 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: 2025 vid: 96 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 191461435 191461435 191461435 10.2340/17453674.2025.44797 191461435 ppf: 763 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Nationwide incidence of lateral malleolar fracture surgery across 6 European countries: has recent evidence changed clinical practice? aug: au: PONKILAINEN, Ville IBOUNIG, Thomas JONES, Tim REITO, Aleksi CRIJNS, Tom J. WHITEHOUSE, Michael FELLÄNDER-TSAI, Li SUTER, Cyrill RÄMÖ, Lasse JÄRVINEN, Teppo L. N. affil: Department of Orthopaedics and Traumatology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa. sug: subj: Ankle Fractures Surgery Fracture Fixation Trends Fracture Fixation Utilization Medical Practice, Evidence-Based Geographic Factors Human Incidence Europe Austria England Finland Germany Sweden Switzerland Matched Case Control Surgical Patients Confidence Intervals Adolescence Adult Middle Age Aged Aged, 80 and Over Retrospective Design Record Review Nonexperimental Studies Odds Ratio Poisson Distribution Regression Descriptive Statistics Weight-Bearing Ankle Fractures Radiography Ankle Fractures Therapy Conservative Treatment Data Analysis Software Ankle Fractures Epidemiology Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over ab: Background and purpose — Increased use of weightbearing radiographs to assess ankle mortise stability have suggested that most lateral malleolar fractures with a congruent mortise on initial radiographs can successfully be treated nonoperatively. We aimed to evaluate trends in the surgical management of isolated lateral malleolus fractures across Austria, England, Finland, Germany, Sweden, and Switzerland from 2013 to 2022 Methods — We performed a multi-register study to document the annual incidence of operative treatment for isolated lateral malleolus fractures through procedure codes across 6 European countries between 2013 and 2022. The annual incidence of operative treatment was calculated by dividing the total number of procedures per year by the year- and agematched population based on publicly available demographics data. Results — Across the 6 studied European countries, the incidence of surgery for lateral malleolar fracture varied 6-fold between the country with highest (Germany) and lowest (England) incidences; Germany: 37 (95% confidence interval [CI] 37–38) per 105; Switzerland: 34 (CI 32–35) per 105, Austria: 27 (CI 26–28) per 105, Finland: 17 (CI 16–18) per 105, Sweden: 8 (CI 7–9) per 105, and England: 6 (CI 6–7) per 105 in 2021. Over the 10-year study period, the incidence of surgery for lateral malleolar fractures declined notably in Sweden (–29%), Finland (–26%), England (–20%), and Switzerland (–14%), but remained stable in Germany and Austria. Conclusion — The incidence of surgery for lateral malleolar fracture varied 6-fold across 6 studied European countries. Reductions of approximately 20–30% were observed in England, Sweden, and Finland (countries with the lowest baseline rates), while in Germany and Austria (countries with higher baseline rates), the incidence of surgery remained stable over the 10-year observation period. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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