Epidemiology and Implant Selection Trends in Ankle Fracture Surgery: A Retrospective Study in a Regional Singaporean Hospital

Background and objective: Ankle fractures are among the most common orthopedic injuries requiring surgical intervention. The evolution of implant technologies and surgical practices has influenced implant selection. We aim to report the trend and cost of implant use for ankle fracture surgery at our institution. Methodology: A rtrospective review of surgical cases from 2016 to 2022 was identified and subdivided into two periods, A (2016–2019) and B (2020–2022), examining patient demographics, fracture types [Arbeitsgemeinschaft für Osteosynthesefragen (AO) and Weber classification], surgical implants used, and temporal trends. The overall cohort data were analyzed for median implant cost and factors associated with higher implant cost. Results: There was no change in the trend of median age or sex of patients or fracture pattern over time. Low-energy fall is the predominant mechanism of injury, followed by sports injury and road traffic accidents. Unimalleolar and Weber B fractures are the most common fracture patterns. In 2016, 79% of cases were performed with standard implants, whereas only 8% of cases used standard implants in 2022. Comparing periods A (2016–2019) and B (2020–2022), the median implant cost has almost doubled. Conclusion: We conclude that the shifts in implant preference reflect evolving surgical strategies and patient-specific considerations. Our findings may inform future implant procurement and influence surgical guidelines.