Hong Kong Med J 2006;12:208-11 | Number 3, June 2006
A prospective case-control study of ankle fracture in postmenopausal women
PY Ho, N Tang, SW Law, HF Tsui, TP Lam, KS Leung
Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
OBJECTIVES. To compare bone mineral density of women with postmenopausal ankle fractures with controls and review patient characteristics, injury mechanisms, and outcomes.
DESIGN. Prospective case-control study.
SETTING. University teaching hospital, Hong Kong.
PARTICIPANTS. Women older than 60 years, admitted with ankle fractures between 2002 and 2003 and controls (age-matched women with femoral neck fractures).
MAIN OUTCOME MEASURES. Demographic data, bone mineral density, mechanism of injury, fracture pattern, treatment, and the functional outcome.
RESULTS. The mean age of the study group (18 ankle fracture patients) was 74 years. The fractures usually resulted from a low-energy trauma; isolated lateral malleolar fracture was the most common (8/18), whilst six had bimalleolar fractures. Their mean T-score bone mineral density values at the spine and hip were -1.67 and -1.70, respectively; corresponding Z-scores were +0.73 and +0.99. The bone mineral density of the study group was significantly higher than in patients with fractured neck of femur (controls) and the general population (P
CONCLUSION. In this case-control study, postmenopausal ankle fractures were not associated with osteoporosis. Diabetic neuropathy may have been a risk factor for such injury. The functional outcome of such patients was generally satisfactory, provided appropriate treatment was given.
Key words: Ankle injuries; Bone density; Fractures, bone; Osteoporosis, postmenopausal
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