Complications of ankle fracture in patients with diabetes

被引:90
作者
Chaudhary, Saad B. [1 ]
Liporace, Frank A. [1 ]
Gandhi, Ankur [2 ]
Donley, Brian G. [3 ]
Pinzur, Michael S. [4 ]
Lin, Sheldon S. [1 ]
机构
[1] Univ Med & Dent New Jersey, New Jersey Med Sch, Dept Orthopaed, Newark, NJ 07103 USA
[2] Univ Med & Dent New Jersey, Newark, NJ 07103 USA
[3] Orthopaed Surg Staff, Cleveland, OH USA
[4] Loyola Univ, Dept Orthoped Surg & Rehabil, Maywood, IL 60153 USA
关键词
D O I
10.5435/00124635-200803000-00007
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Ankle fractures in patients with diabetes mellitus have long been recognized as a challenge to practicing clinicians. Complications of impaired wound healing, infection, malunion, delayed union, nonunion, and Charcot arthropathy are prevalent in this patient population. Controversy exists as to whether diabetic ankle fractures are best treated noninvasively or by open reduction and internal fixation. Patients with diabetes are at significant risk for soft-tissue complications. In addition, diabetic ankle fractures heal, but significant delays in bone healing exist. Also, Charcot ankle arthropathy occurs more commonly in patients who were initially undiagnosed and had a delay in immobilization and in patients treated nonsurgically for displaced ankle fractures. Several techniques have been described to minimize complications associated with diabetic ankle fractures (eg, rigid external fixation, use of Kirschner wires or Steinmann pins to increase rigidity). Regardless of the specifies of treatment, adherence to the basic principles of preoperative planning, meticulous soft-tissue management, and attention to stable, rigid fixation with prolonged, protected immobilization are paramount in minimizing problems and yielding good functional outcomes.
引用
收藏
页码:159 / 170
页数:12
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