title: Risk Factors for Open Malleolar Fractures: An Analysis of the National Trauma Data Bank (2007 to 2011).
abstract: A limited number of studies have described the epidemiology of open fractures, and the epidemiology of open ankle fractures is not an exception. Therefore, the risk factors associated with open ankle fractures have not been extensively evaluated. The frequencies and proportions of open ankle fractures among all the recorded malleolar fractures in the US National Trauma Data Bank data set from January 2007 to December 2011 were analyzed. Clinically relevant variables captured in the data set were also used to evaluate the risk factors associated with open ankle fractures, adjusting for other covariates. The entire cohort was further subdivided into "lower" and "higher" energy trauma groups and the same analysis performed for each group separately. We found that a body mass index of >40 kg/m(2) and farm location were risk factors for open ankle fractures and impaired sensorium was protective against open ankle fractures. In the "lower energy" group, male gender, alcohol use, peripheral vascular disease, other injuries, and injury occurring at a farm location were risk factors for open fractures. In the "higher energy" group, female gender, work-related injury, and injury at a farm or industry location demonstrated statistically significantly associations with open fractures.
authors.affiliation: Associate Professor, Department of Surgery, Texas A&M Health Science Center, College of Medicine, and Chief, Section of Podiatry, Surgical Services, Central Texas Veterans Affairs Health Care System, Temple, TX. Electronic address: shibuya@medicine.tamhsc.edu.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Shibuya
authors.affiliation: Assistant Professor, Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: George T
authors.initials: GT
authors.lastname: Liu
authors.affiliation: Associate Professor, Department of Surgery, Texas A&M Health Science Center, College of Medicine, and Director of Trauma, Baylor Scott and White Healthcare System, Central, Temple, TX.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Davis
authors.affiliation: Private Practice, Akron, OH.
authors.forename: Jordan P
authors.initials: JP
authors.lastname: Grossman
authors.affiliation: Assistant Professor, Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, Texas.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Jupiter
mesh_terms: D000328:Adult; D064386:Ankle Fractures / Q000453:epidemiology* / Q000209:etiology; D016208:Databases, Factual; D005260:Female; D005597:Fractures, Open / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: ankle; epidemiology; prevalence; registry; surgery