Diabetic Pilon Factures: Are They as Bad as We Think?

Area of Science:

• Orthopedic Surgery
• Diabetic Complications
• Trauma Care

Background:

• Pilon fractures are severe lower-extremity injuries often requiring surgical fixation.
• Diabetes mellitus is a prevalent comorbidity that may affect surgical outcomes.

Purpose of the Study:

• To investigate the association between diabetes and the risk of surgical complications following pilon fracture fixation.
• To identify specific complications more frequent in diabetic patients undergoing pilon fracture surgery.

Main Methods:

• Retrospective cohort study of 279 pilon fractures (OTA/AO 43) treated with open reduction and internal fixation.
• Patients were stratified into diabetic and non-diabetic groups.
• Multivariable logistic regression identified independent predictors of complications.

Main Results:

• Diabetic patients had higher BMI and were older at injury.
• Despite less complex fractures, diabetic patients were 5.5 times more likely to need arthrodesis and 2.7 times more likely to develop deep infection.
• Overall, diabetic patients were 3.64 times more likely to experience any complication.

Conclusions:

• Diabetes is an independent risk factor for surgical complications after pilon fracture fixation.
• Management strategies should consider the increased complication risk in diabetic patients.
• Further research into mitigating these risks is warranted.