Diabetic Neuropathy Is an Independent Risk Factor for Poor Orthopaedic Outcomes After Operatively Treated Ankle...

Area of Science:

• Orthopedic Surgery
• Diabetology
• Podiatry

Background:

• Diabetic neuropathy is a common complication of diabetes.
• Ankle fractures are common injuries that often require surgical intervention.
• The impact of diabetic neuropathy on surgical outcomes for ankle fractures is not well understood.

Purpose of the Study:

• To investigate the impact of diabetic neuropathy on operative bimalleolar or trimalleolar ankle fracture outcomes.
• To compare outcomes between patients with diabetic neuropathy, diabetic patients without neuropathy, and non-diabetic patients.

Main Methods:

• Retrospective comparative study using the TriNetX research network (2005-2022).
• Inclusion of patients with operative bimalleolar or trimalleolar ankle fractures (OTA/AO 44).
• Propensity score matching and logistic regression to compare postoperative complications.

Main Results:

• Patients with diabetic neuropathy had a higher risk of malunion/nonunion (RR 1.79 vs. non-diabetics, RR 2.35 vs. diabetics without neuropathy).
• Increased risk of implant infection (RR 2.12 vs. non-diabetics, RR 2.25 vs. diabetics without neuropathy).
• Significantly higher risk of amputation in patients with diabetic neuropathy (RR 8.01 vs. non-diabetics).

Conclusions:

• Diabetic neuropathy is associated with significantly higher rates of postoperative complications after ankle fracture surgery.
• These complications include malunion, nonunion, implant infection, and amputation.
• Patients with diabetic neuropathy represent a high-risk group for adverse surgical outcomes.