title: Ankle fractures in patients with diabetes mellitus.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242-1088, USA. kevin-jones@uiowa.edu
authors.forename: K B
authors.initials: KB
authors.lastname: Jones
authors.forename: K A
authors.initials: KA
authors.lastname: Maiers-Yelden
authors.forename: J L
authors.initials: JL
authors.lastname: Marsh
authors.forename: M B
authors.initials: MB
authors.lastname: Zimmerman
authors.forename: M
authors.initials: M
authors.lastname: Estin
authors.forename: C L
authors.initials: CL
authors.lastname: Saltzman
mesh_terms: D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000150:complications* / Q000601:surgery / Q000628:therapy; D048909:Diabetes Complications / Q000150:complications*; D005260:Female; D005592:Fracture Fixation / Q000379:methods; D050723:Fractures, Bone / Q000150:complications* / Q000601:surgery / Q000628:therapy; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014946:Wound Infection / Q000209:etiology