Special Considerations in the Management of Diabetic Ankle Fractures

Manway, Jeffrey M.; Blazek, Cody D.; Burns, Patrick R.

doi:10.1007/s12178-018-9508-x

Cited by 22 publications

(16 citation statements)

References 52 publications

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“…According to the International Diabetes Federation (IDF), the global prevalence of DM in 2011 was 366 million, but it is estimated that in 2030 DM will affect 552 million of people 9,10 . Therefore, it is reported ankle/tibial plafond fractures and diabetes mellitus are both increasing in prevalence 7 . Patients with both diabetes and an ankle fracture have been shown to have an increased rate of complications which can be catastrophic 7 .…”

Section: Patient Comorbiditiesmentioning

confidence: 99%

“…Therefore, it is reported ankle/tibial plafond fractures and diabetes mellitus are both increasing in prevalence 7 . Patients with both diabetes and an ankle fracture have been shown to have an increased rate of complications which can be catastrophic 7 . It is reported that medical expenses for diabetic patients are over two times higher than nondiabetics and the total cost of DM management was about $ 245 billion dollars in 2012 in the USA 11 .…”

Section: Patient Comorbiditiesmentioning

confidence: 99%

“…Specifically, mean length of hospital stay and healthcare cost of ankle and tibial plafond fractures of patients with diabetes have been found to be significantly higher (p < 0.01) 12 . Furthermore, patients with complicated diabetes have longer hospital stays (p < 0.01) and are $ 6895 more costly than uncomplicated diabetic patients 7,12 . Therefore, these patients, being extremely complicated, present multifaceted challenges for surgeons 7 .…”

Section: Patient Comorbiditiesmentioning

confidence: 99%

“…Furthermore, patients with complicated diabetes have longer hospital stays (p < 0.01) and are $ 6895 more costly than uncomplicated diabetic patients 7,12 . Therefore, these patients, being extremely complicated, present multifaceted challenges for surgeons 7 . It is remarkable that, while several papers discuss the perils of management of diabetic ankle fractures, there is little evidence on the optimal treatment for these injuries.…”

Section: Patient Comorbiditiesmentioning

confidence: 99%

“…fracture healed in a position of deformity -are two dreadful complications that can be observed in specific types of patients and fracture patterns. Diabetes, increased age, obesity, peripheral arterial disease, and non-ambulation are risk factors for nonunion 7 . Malunion, on the other hand, can be a frequent complication in supinationadduction injuries, with articular impaction of the tibial plafond, incorrectly managed at the time of surgery 8 .…”

Section: Introductionmentioning

confidence: 99%

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Malunions and nonunions following tibial malleolar and tibial plafond fractures: current concepts

et al. 2020

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Ankle fractures or fracture-dislocations account for about 4-5% of all body fractures, with approximately 120-180/100,000 affected persons/year. Tibial pilon fractures are relatively infrequent, accounting for 5-7% of all fractures of the tibia. This review aims to summarize the current evidence on malunions and nonunions following tibial malleolar and tibial plafond fractures and to give some tips to avoid such complications. Malunion and nonunion following tibial malleolar and plafond fractures are quite rare but dreadful complications. Accurate evaluation of comorbidities and optimization of the patient's health should be done before surgery. Multiple recent retrospective studies have shown that ankle/ tibial plafond fractures treated within 72 h of surgery have comparable outcomes to staged fixation, the two-stage protocol is the most commonly used approach for the treatment of high-energy intra-articular injuries of the distal tibia. Several surgical approaches have been described for the management of ankle and tibial plafond fractures. Each one of these approaches has its own advantages and disadvantages, hence, it is important to recognize that no one approach is right for all patients. Surgeons managing these complex fractures should be comfortable with the various approaches to the distal tibia and be prepared to use whichever approach is suitable for the individual soft tissues and fracture pattern. Finally, with improvements in surgical techniques and implants, complication rates following ankle and tibial plafond fractures have declined, and outcomes have improved.

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