Operative Ankle Fractures in Complicated Diabetes: Outcomes of Prolonged Non-Weightbearing

Area of Science:

• Orthopedic Surgery
• Diabetology
• Podiatry

Background:

• Diabetes mellitus significantly elevates the risk of postoperative complications, including infection and wound dehiscence, particularly in ankle fracture cases.
• Complicated diabetic ankle fractures require careful management to mitigate adverse outcomes.

Purpose of the Study:

• To compare postoperative complication rates in complicated diabetic ankle fractures based on weightbearing status.
• To investigate the impact of prolonged non-weightbearing and augmented fixation on surgical outcomes.

Main Methods:

• Retrospective review of 90 surgically treated complicated diabetic ankle fractures.
• Analysis of weightbearing status (prolonged non-weightbearing defined as ≥ 8 weeks), augmented fixation, and postoperative complications.
• Statistical analysis to identify risk factors, including HbA1c and creatinine levels.

Main Results:

• 36.7% of patients experienced postoperative complications.
• Prolonged non-weightbearing showed a trend towards fewer complications (29.2% vs 39.4%), associated with higher HbA1c levels.
• Increased creatinine levels (one-unit increase) correlated with a 3.15-fold higher risk of complications (p=0.01).

Conclusions:

• Prolonged non-weightbearing may be beneficial for reducing complications in complicated diabetic ankle fractures, though not statistically significant in this study.
• Creatinine level is identified as an independent risk factor for postoperative complications in this patient population.
• Further research is warranted to optimize management strategies for diabetic ankle fractures.