title: Effect of the blood HbA1c level on surgical treatment outcomes of diabetics with ankle fractures.
abstract: OBJECTIVE
  To investigate whether blood haemoglobin A 1c (HbA1c) levels was predicative of diabetic patients' responsiveness to surgical treatment of ankle fractures.
  
  
  METHODS
  The relationship between blood HbA1c levels and surgical treatment outcomes of 21 diabetic patients undergoing open reduction internal fixation (ORIF) for ankle fractures was analyzed with Pearson correlation testing and t testing. All patients were treated with ORIF using standard surgical techniques. Treatment outcomes were defined using radiological outcome, the American Orthopaedic Foot and Ankle Score (AOFAS) ankle-hindfoot scale score, surgical revision rate, and complication rate.
  
  
  RESULTS
  HbA1c levels were found to have a statistically significant correlation with poor radiological outcomes (r = 0.547) and AOFAS ankle-hindfoot scores (r = -0.592). Additionally, though rates of poor radiological outcome, revision, and complication were high in the diabetic population as a whole, these rates were considerably higher among individuals with elevated HbA1c (≥6.5%) and considerably lower among individuals with lower HbA1c (<6.5%) levels.
  
  
  CONCLUSIONS
  Blood HbA1c levels appear to be predictive of risk and complication rates in the surgical treatment outcomes of diabetic patients with ankle fractures.
authors.affiliation: Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, Ohio 43614, USA. jiayong.liu@utoledo.edu
authors.forename: Jiayong
authors.initials: J
authors.lastname: Liu
authors.forename: Todd
authors.initials: T
authors.lastname: Ludwig
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Ebraheim
mesh_terms: D000328:Adult; D000368:Aged; D064386:Ankle Fractures; D015415:Biomarkers / Q000097:blood; D048909:Diabetes Complications / Q000097:blood*; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D017759:Fractures, Malunited / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology; D005599:Fractures, Ununited / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011859:Radiography; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Ankle fracture; Diabetes mellitus; Hemoglobin A 1c