Calcaneus fractures, epidemiology and treatment – Data on 3 949 fractures from the Swedish Fracture Register

IF 2 3区医学 Q2 ORTHOPEDICS Foot and Ankle Surgery Pub Date : 2024-11-13 DOI:10.1016/j.fas.2024.11.004

Anna Rubenson , Maziar Mohaddes , Malin Carling , Carl Bergdahl

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Abstract

Background

Due to changing population demographics and evolving treatment strategies updated epidemiological data are needed. This study aims to provide nationwide epidemiology data regarding calcaneus fractures of all types and treatment.

Methods

The study is based on data from the Swedish Fracture Register and include patients ≥ 18 with a calcaneus fracture sustained between April 2012 and June 2022. Patient characteristics, injury mechanism, fracture classification and primary treatment were analysed. With access to data on each separate fracture, all bilateral fractures, n = 320, could be identified and were studied in a separate analysis.

Results

The study included 3629 unilateral calcaneus fractures in 3618 patients. The mean age was 48 years (SD ± 18) and 2178 (60 %) were men. Fall from height was the most common mechanism of injury (n = 1683; 46 %) and high-energy trauma was documented in 887(28 %) patients. Overall, AO/OTA type A fractures (avulsion), and type C fractures (intra-articular) was equally common, but the type C fracture was the most common fracture type in men. The vast majority of type A (n = 1105; 89 %) and B (n = 717; 93 %) fractures were treated non-surgically, while surgical treatment was more common in type C (n = 499; 43 %) fractures. Fracture fixation with plate and screws was the most common surgical method. Arthrodesis as a primary treatment was rarely used.

Of the patients with bilateral fractures 80 % were male, (n = 128). They were generally younger (mean age of 38 years (SD±14.5, p < 0001) and had a larger proportion of high-energy traumas, n = 107 (67 %) compared with patients with unilateral fractures.

Conclusion

Calcaneus fractures occur most frequently in the middle-aged population, and the majority of patients are male. The difference in prevalence between men and women is less pronounced than previous studies have shown. In male patients the fractures were more severe, more often caused by high-energy trauma, and more frequently treated surgically.

Level of evidence

IV, retrospective observational cohort study

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钙骨骨折、流行病学和治疗 - 来自瑞典骨折登记册的 3 949 例骨折数据。

背景：由于人口结构的变化和治疗策略的发展，需要更新流行病学数据。本研究旨在提供有关各种类型的小关节骨折和治疗的全国性流行病学数据：该研究基于瑞典骨折登记处的数据，包括2012年4月至2022年6月期间≥18岁的小关节骨折患者。研究分析了患者特征、受伤机制、骨折分类和主要治疗方法。由于可以获得每个独立骨折的数据，因此可以确定所有双侧骨折（n = 320），并在单独的分析中进行研究：研究包括3618名患者的3629处单侧方骨骨折。平均年龄为 48 岁（SD ± 18），男性患者为 2178 人（60%）。高处坠落是最常见的受伤机制（n = 1683；46%），887（28%）例患者有高能量创伤记录。总体而言，AO/OTA A型骨折（撕脱伤）和C型骨折（关节内骨折）同样常见，但C型骨折是男性最常见的骨折类型。绝大多数 A 型（n = 1105；89%）和 B 型（n = 717；93%）骨折采用非手术治疗，而手术治疗在 C 型（n = 499；43%）骨折中更为常见。用钢板和螺钉固定骨折是最常见的手术方法。很少使用关节固定术作为主要治疗方法。在双侧骨折患者中，80%为男性（n = 128）。他们的年龄普遍较小（平均年龄为 38 岁（SD±14.5，P））：钙骨骨折多发于中年人群，且大多数患者为男性。男女发病率的差异没有以往研究显示的那么明显。男性患者的骨折更为严重，更多是由高能量创伤引起，更多采用手术治疗：IV，回顾性观察队列研究。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.