title: The effect of inclement weather on ankle fracture management in an Irish trauma unit.
abstract: BACKGROUND
  Ireland is unfamiliar with extreme weather conditions. Such conditions occurred in winter 2009-2010 and 2010-2011, with much of the country being affected by snow and ice. We reviewed the effect that these conditions had on the treatment of ankle fractures in our trauma unit.
  
  
  METHODS
  The study period was from November until February for four consecutive years from 2008-2009 until 2011-2012. We compared two winters with extreme weather with two winters with regular weather conditions. Information from Met Eireann was compared with demographics from patient records to differentiate ice-related injuries from non-ice-related injuries. Ankle fractures were classified using the Lauge-Hansen classification. We compared waiting times in A&E, waiting times for theatre, delays relating to injury severity, and overall length of stay for both groups.
  
  
  RESULTS
  We identified 44 ice-related injuries and 67 non-ice-related injuries. Ice-related injuries trended towards more severe fracture configurations using the Lauge-Hansen classification. Patients sustaining ankle injuries during inclement weather were significantly younger than patients sustaining injuries during regular weather conditions. There were no other significant differences between the two groups.
  
  
  CONCLUSIONS
  Ice-related injuries trended towards a greater severity of fracture configuration. We identified no significant increase in the time to treatment or overall length of stay of patients sustaining ankle fractures during these times. Ice-related injuries did not have greater rates of complications. These results are a testament to the trauma staff in this unit who absorbed the increased workload without compromising patient care.
authors.affiliation: Department of Trauma and Orthopaedics, Connolly Hospital Blanchardstown, Blanchardstown, Dublin 15, Ireland. barryoneill1922@gmail.com
authors.forename: B J
authors.initials: BJ
authors.lastname: O'Neill
authors.forename: E G
authors.initials: EG
authors.lastname: Kelly
authors.forename: O C
authors.initials: OC
authors.lastname: Breathnach
authors.forename: P
authors.initials: P
authors.lastname: Keogh
authors.forename: P J
authors.initials: PJ
authors.lastname: Kenny
authors.forename: S J
authors.initials: SJ
authors.lastname: O'Flanagan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064386:Ankle Fractures; D016512:Ankle Injuries / Q000453:epidemiology*; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014887:Weather; D055815:Young Adult