Complications encountered with circular ring fixation in persons with diabetes mellitus.
BACKGROUND
The purpose of this study was to identify and report the complications associated with the use of circular ring fixation in diabetic patients, and to compare the frequency of complications in patients without diabetes. We hypothesized that complications with circular ring fixation occurred more frequently in patients with diabetes than patients without diabetes.


METHODS
Institutional Review Board approval was obtained and patient charts were retrospectively reviewed from June 2004 and February 2007. Fifty six consecutive patients undergoing midfoot, hindfoot and/or ankle surgery were treated with circular ring fixation which included 33 diabetic patients in the study group and 23 non-diabetic patients in the control group. Patient demographics, the duration of treatment with the external fixator, and complications were recorded.


RESULTS
Males had a greater number of complications compared to females (p = 0.0014). The total number of complications was statistically greater in diabetic patients (study group) versus non-diabetic patients (control group) (p = 0.003). In multivariate logistic regression, diabetes and male sex were the only significant variables associated with wire complications (OR 7.35, 95% CI 1.93-28.04 and OR 0.22, 95% CI 0.05-8584111, respectively).


CONCLUSIONS
Women are protected from wire complications with a risk reduction of 78% compared to males. Diabetics have a 7-fold risk for any wire complication compared to patients without diabetes. We found no adverse effects of BMI, obesity, age, smoking, neuropathy, or Charcot neuroarthropathy on a satisfactory recovery.
UPMC Comprehensive Foot and Ankle Center, Roesch-Taylor Bldg., 2100 Jane St., Ste 7300, Pittsburgh, PA, 15203, USA. wukichdk@upmc.edu
Dane K
DK
Wukich
Ronald J
RJ
Belczyk
Patrick R
PR
Burns
Robert G
RG
Frykberg
D000368:Aged; D000843:Ankle Joint / Q000601:surgery*; D001177:Arthropathy, Neurogenic / Q000601:surgery; D016022:Case-Control Studies; D048909:Diabetes Complications; D005260:Female; D017759:Fractures, Malunited / Q000601:surgery; D006801:Humans; D018889:Ilizarov Technique / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors