Association Between Diabetes, Obesity, and Short-Term Outcomes Among Patients Surgically Treated for Ankle Fracture

Cavo, Matthew; Fox, Justin P.; Markert, Ronald J.; Laughlin, Richard T.

doi:10.2106/jbjs.n.00789

Cited by 48 publications

(42 citation statements)

References 20 publications

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“…8,10,11,13,14,16,44 Further risk factors that may coincide with diabetes are obesity, peripheral vascular disease and smoking. 15,16 Low-energy open fractures are particularly prone to complications, with reported wound complications in up to 64% of patients, infection rates of up to 36%, subsequent below-knee amputation in up to 42% and a two-month mortality of 27%. 45 Although the studies available have low patient numbers, the impact of skin ageing in open fractures is well-recognised.…”

Section: Results and Complicationsmentioning

confidence: 99%

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Management of ankle fractures in the elderly

Rammelt

2016

EFORT Open Reviews

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The incidence and severity of ankle fractures in elderly patients is increasing steadily. These injuries are challenging to treat and prone to complications.Individual fracture treatment is tailored depending on bone quality, skin conditions, comorbidities, and functional demand of the patient. This article provides a review of current techniques to obtain stable fixation despite poor bone quality. To avoid complications, it is imperative to consider and treat comorbidities such as diabetes and osteoporosis.In the absence of severe systemic comorbidities, the results after open reduction and internal fixation of malleolar fractures in patients above and below 60 years of age are nearly identical, while nonoperative treatment of unstable fractures leads to significantly inferior outcomes. Therefore, the general indications for surgery in elderly patients should not differ from those in younger patients.However, it is essential to detect severe conditions such as Charcot neuro-osteoarthropathy because these require a completely different treatment regime, and standard internal fixation will invariably fail in these patients.Cite this article: Rammelt S. Management of ankle fractures in the elderly. EFORT Open Rev 2016;1:239-246. DOI: 10.1302/2058-5241.1.000023.

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Section: Results and Complicationsmentioning

confidence: 99%

“…15 Obesity has been identified as an independent risk factor for complications and poorer outcomes in both diabetics and non-diabetics. 16 …”

Section: Diabetes Mellitusmentioning

confidence: 99%

Management of ankle fractures in the elderly

Rammelt

2016

EFORT Open Reviews

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“…This is evident in the study by Folk et al [11], wherein diabetes, smoking, and open fracture were shown to be independent and significant risk factors for wound complications after surgical stabilization of calcaneus fractures. Other authors also have emphasized the effects of peripheral neuropathy, medications, and noncompliance on prognosis in fracture treatment [4,24,26].…”

Section: Limitationsmentioning

confidence: 99%

Classifications In Brief: The Tscherne Classification of Soft Tissue Injury

Ibrahim

Swenson

Sassoon

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…Weichteilkompromittierende Frakturdislokationen und -luxationen sollten sofort reponiert werden, um einem sekundären Weichteilschaden vorzubeugen. Glucose und HbA1c bietet sich insbesondere auch für die weitere Therapie an [6,20]. Eine Reduktion von 1 % HbA1c führt zu einer geschätzten Reduktion der Komplikationsrate von 25-30 %.…”

Section: Welche Unterschiede Zum Jüngeren Patienten Bestehen Beim äLtunclassified

Frakturen des Fußes beim älteren Patienten – was ist anders?

Ochman¹,

Raschke²

2017

OP-JOURNAL

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ZusammenfassungIm Gegensatz zu Frakturen des oberen Sprunggelenkes sind Frakturen des Fußes keine typischen Verletzungen des älteren Patienten. Die aktuelle Literatur liefert nur wenige Erkenntnisse über die Besonderheiten oder Unterschiede zum jüngeren Patienten. Dennoch sind Verletzungen des Fußes nicht selten in dieser Altersgruppe, zum einen bedingt durch Risikofaktoren wie eine osteoporotische Knochenstruktur und Sturzneigung, zum anderen bedingt durch den mittlerweile hohen Aktivitätslevel der Patienten. Die Behandlung stellt aufgrund der oftmals kompromittierten Weichteilverhältnisse, der schlechten Knochenqualität, vorbestehender Deformitäten sowie degenerativer Veränderungen und der häufig nicht einzuhaltenden Teilbelastung im Rahmen der Behandlung eine Herausforderung dar. Im Gegensatz zum jüngeren Patienten finden sich beim älteren andere Frakturmorphologien sowie therapeutisch andere Gesichtspunkte aufgrund von Komorbiditäten. Wie auch beim jungen Patienten steht die Wiederherstellung der Funktion und Mobilität an oberster Stelle des therapeutischen Regimes.

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Association Between Diabetes, Obesity, and Short-Term Outcomes Among Patients Surgically Treated for Ankle Fracture

Abstract: We found that patients with concurrent diagnoses of diabetes and obesity had higher health-care utilization and costs than those with neither diagnosis or with obesity alone or diabetes alone. The delay in the diagnosis of diabetes may somewhat obscure the true effect.

Cited by 48 publications

References 20 publications

Management of ankle fractures in the elderly

Management of ankle fractures in the elderly

Classifications In Brief: The Tscherne Classification of Soft Tissue Injury

Frakturen des Fußes beim älteren Patienten – was ist anders?

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