Identifying a specific fracture pattern on x-ray film in adult patients with fragility fractures of the ankle seen at Chris Hani Baragwanath Academic Hospital

Abstract

Purpose: The study aimed to identify a specific fracture pattern on x-ray film that characterises bone fragility of ankle fractures in adult patients seen at Chris Hani Baragwanath Academic Hospital from 01 January 2022 to 31 December 2024. Method: Data was collected from 276 adult patients seen at Chris Hani Baragwanath Academic Hospital with ankle fractures from 01 January 2022 to 31 December 2024. The population age range was from 18 years old and above. Patient information and x-ray findings were recorded on a data collection sheet (Appendix A). Results: A total of 276 observations were recorded, comprising 137 females (49.6%) and 139 males (50.4%). The largest age group represented was 29 − 39 years, with 105 individuals (38.0%). The Danis-Weber (D-W) B2 ankle fracture was the predominant type, accounting for 173 cases (62.7%), and also noted as a prevalent pattern statistically. Additionally, fragility fractures were observed in 66.7% of the participants, with a higher prevalence among females (76.64%) compared to males (53.83%). Out of the participants, 182 reported alcohol use (65.9%), while 82 were smokers (29.7%). The body mass index and age were found to be moderately and marginally significant risk factors, respectively. Conclusion: The results of this study differ slightly from international studies, given the limitations and population age group. The predominance of D-W B2 fractures suggests fragility, particularly when associated with comminution and a history of a simple twist or fall. A more thorough assessment using objective measures, such as CT scans, DXA scans, or evaluations of cortical thickness, alongside X-ray films, could provide more specific insights into the fracture patterns. It is also essential to conduct individualised risk assessments for both males and females across various age groups while implementing strategies to minimise recall bias and social desirability bias.