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

Kara L Holloway,  David M Moloney, Sharon L Brennan, Mark A Kotowicz, Gosia Bucki-Smith, Elizabeth N Timney, Amelia G Dobbins and Julie A Pasco

Objective: The aim of this study was to report the incidence of all foot and ankle fractures during 2006 and 2007 among residents from the Barwon Statistical Division, located in south-eastern Australia.

Methods: Incident fractures were ascertained using X-ray reports from the imaging centres serving the region during the years 2006 and 2007. All fractures with ICD-9 code 824 (ankle) or 825 (foot) were included in this study. Age, proportions of left/right side fractures, cause of fracture and incidence rates (per 10,000 person-years) were all determined for foot and ankle fractures separately as well as for the two sites combined.

Results: There were 312 males and 274 females identified with foot fractures and 344 males and 410 females with ankle fractures. The median age for both foot and ankle fracture was lower in males compared to females. The proportions of left and right side fractures were approximately equal; no sex or site (foot or ankle) showed higher proportions of either left or right side fractures. Among those for whom cause of fracture was known, most foot or ankle fractures (>75%) in both sexes were caused by an accidental fall. For both sexes, there was a bimodal pattern of incidence across the age groups, with peaks around adolescence/early adulthood and in the elderly. Incidence rates (per 10,000 person-years) for foot and ankle fractures combined were similar in both sexes; 25.85 and 25.88 for males and females, respectively. However, the incidence rate for foot/ankle fractures combined in those aged 50 years or over was lower in males than in females.

Conclusion: Males sustained foot and ankle fractures at a lower median age than females and most fractures were the result of an accidental fall. Males sustain fractures mainly during adolescence and young adulthood, whereas fractures in females were sustained largely by individuals over 50 years of age. Despite this, the overall incidence rates were similar for both sexes.