Epidemiological study of foot and ankle fractures among Civil Servants in the State of São Paulo

Abstract

Objective: The treatment of foot and ankle fractures accounts for a significant portion of orthopedic surgeries performed by the Instituto de Assistência Médica ao Servidor Público Estadual [Medical Care Institute for State Civil Servants] (IAMSPE). The objective of this study was to outline the epidemiological profile of foot and ankle fractures treated surgically, and based on these data, to establish strategies for prevention, in order to decrease the social and economic impact of this injury in the population served by our hospital. Methods: Over an eleven­year period, information was gathered prospectively on all patients with foot and ankle fractures treated with surgery. Data were recorded on sex, age, side affected, surgical procedure performed, and immediate and later complications. Results: 1028 fractures were operated on, the most frequent site being the ankle, with 740 cases, followed by the calcaneus/heel, tibial pilon, Lisfranc, talus, metatarsus, phalanges/toes, and navicular. The mean age was 51.7 years, and women represented the majority of cases, with 56.4%. One patient required surgical cleaning for treatment of postoperative infection. 43 had removal of synthesis material, and 11 were submitted to surgical treatment of post­traumatic arthrodesis. Conclusion: The majority were low­impact fractures, and fractures were particularly prevalent among women during the menopause. Early complications were rare, and later complications, such as post­traumatic arthritis, were more common in high­impact fractures, especially of the talus.