The Seasonal Nature of Ankle Injuries

Introduction: The diagnostics of ankle injuries remains challenging. It is expected that ankle injuries in winter are caused by higher energy than in summer. The aim of the study is to evaluate incidence according Lauge-Hansen classification, focused on the trauma mechanism between ankle injuries in summer and winter period.

Materials and Methods: A retrospective study of patients with ankle injuries, admitted in the Hospital of Traumatology and Orthopaedics from December 2015 to February 2016 (Group 1) and from June to August 2016 (Group 2) was conducted. Inclusion criteria in Group 1 were information in the patients’ case record about injury related to ice. The patients who suffered high energy trauma were excluded from the study. The type of ankle injuries was evaluated according to the Lauge-Hansen classification using patient’s preoperative and postoperative ankle radiographs in the clinical database.

Results: In the Group 1 30 patients (8 male, 22 female, mean age 47.8 years), in the Group 2 35 patients (15 male, 20 female, mean age 47.1 years) met the inclusion criteria. According to the Lauge-Hansen classification supination-external rotation injuries in the Group 1 were 86.7% (n = 26) vs. Group 2 57.1% (n = 20); pronation-external rotation injuries in the Group 1 were 10% (n = 3) vs. Group 2 22.8% (n = 8); supination-adduction injuries in the Group 1 were 3.3% (n = 1) vs. Group 2 5.7% (n = 2); pronation-abduction injuries in the Group 2 were 14.3% (n = 4).

Discussion and conclusions: This study highlights the incidence of injury types, caused by different trauma mechanism and energy in winter and summer as well as necessity of the hospital resources planning. This data can be useful for comparative assessment of treatment outcomes in countries in different climatic zones. We recommend careful evaluation of the ankle injuries using Lauge-Hansen classification since the injury type is essential in the diagnostics and preparation to the appropriate surgical treatment. Further studies need to be conducted.