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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 4, 489-495.
doi: 10.1302/0301-620X.87B4.15724  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Ankle fractures in patients with diabetes mellitus

K. B. Jones, MD, Resident1; K. A. Maiers-Yelden, MD, Resident2; J. L. Marsh, MD, Professor of Orthopaedic Surgery1; M. B. Zimmerman, PhD, Associate Professor of Biostatistics3; M. Estin, Student Research Assistant1; and C. L. Saltzman, MD, Professor of Orthopaedic Surgery1

1 Department of Orthopaedic Surgery
2 Department of General Surgery
3 Department of Biostatistics, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242-1088, USA.

Correspondence should be sent to Dr K. B. Jones; e-mail: kevin-jones{at}uiowa.edu

Diabetes mellitus is considered an indicator of poor prognosis for acute ankle fractures, but this risk may be specific to an identifiable subpopulation. We retrospectively reviewed 42 patients with both diabetes mellitus and an acute, closed, rotational ankle fracture. Patients were individually matched to controls by age, gender, fracture type, and surgical vs non-surgical treatment. Outcomes were major complications during the first six months of treatment. We contrasted secondarily 21 diabetic patients with and 21 without diabetic comorbidities. Diabetic patients and controls did not differ significantly in total complication rates. More diabetic patients required long-term bracing. Diabetic patients without comorbidities had complication rates equal to their controls. Diabetic patients with comorbidities had complications at a higher rate (ten patients; 47%) than matched controls (three patients; 14%, p = 0.034). A history of Charcot neuroarthropathy led to the highest rates of complication. An increased risk of complications in diabetic patients with closed rotational fractures of the ankle are specific to a subpopulation with identifiable related comorbidities.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General