Infection Rates in Singaporeans with and without Complicated Diabetes after Ankle Fracture Surgery

Tan, Tze Guan; Oh, Jacob Yoong-Leong; Kwek, Ernest Beng Kee

doi:10.1177/230949901502300114

Cited by 8 publications

(4 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Higher age, current smoking, and diabetes are risk factors for deep infection following many orthopaedic procedures [11,[26][27][28][29]. In the present study, age and smoking were associated with implant removal, whereas diabetes was not.…”

Section: Discussionsupporting

confidence: 47%

Incidence and risk factors for removal of an internal fixation following surgery for ankle fracture: A retrospective cohort study of 997 patients

Naumann

Sigurdsen

Utvåg

et al. 2016

Injury

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 47%

Incidence and risk factors for removal of an internal fixation following surgery for ankle fracture: A retrospective cohort study of 997 patients

Naumann

Sigurdsen

Utvåg

et al. 2016

Injury

View full text Add to dashboard Cite

“…found that a higher proportion of diabetic patients undergoing nerve biopsy had wound infections in comparison to nondiabetics (Theriault et al, 1998). We suspect that underlying comorbidities and more specifically diabetes is the primary factor in the difference between the two groups, because diabetes is a well-established risk factor for postoperative infections (Tan, Oh, & Kwek, 2015). The diabetic patients who were getting sural nerve biopsies for the workup of peripheral neuropathy at baseline likely had poorly controlled diabetes as indicated by the progression of neuropathy.…”

Section: Discussionmentioning

confidence: 94%

Chronic postoperative complications and donor site morbidity after sural nerve autograft harvest or biopsy

Dučić

Yoon

Buncke³

2020

Microsurgery

View full text Add to dashboard Cite

Background The sural nerve is the most frequently harvested nerve autograft and is most often biopsied in the workup of peripheral neuropathy. While the complication types associated with these two procedures are well known, their clinical significance is poorly understood and there is a paucity of data regarding the complication rates. Methods Pubmed search identified studies regarding complications after sural nerve harvest and biopsy. The data was grouped into sensory deficits, chronic pain, sensory symptoms, wound infections, wound complications, other postoperative complications, and complications impacting daily life. The incidence of each complication was calculated, and a chi‐square analysis was performed to determine if there were any differences between nerve biopsies and graft harvest with respect to each complication. Results Twelve studies yielded 478 sural nerve procedures. Sensory deficits occurred at a rate of 92.9%, chronic pain at 19.7%, sensory symptoms at 41.1%, wound infections at 5.7%, noninfectious wound complications at 7.8%, and impact on daily life at 5.0%. The differences in wound infections, sensory symptoms, and impact on daily life between biopsies versus graft excisions were found to reach statistical significance (p < .05). Conclusions Sural nerve excisions can cause chronic postoperative donor‐site complications. Given these complications, alternative available mediums for nerve reconstruction should be explored and utilized wherever appropriate. If an alternative medium is unavailable and nerve autograft must be harvested for nerve reconstruction, then patients should be counseled about risks for developing donor site complications that may negatively affect quality of life.

show abstract

“…They found an increased rate of complication (50% vs. 22.8%, OR 3.8 p ¼ 0.003), non-infectious complication (malunion, non-union and Charcot; 28.9% vs. 11.9%, OR 3.4 p ¼ 0.02) and revision surgery (26.7% vs. 6.8%, OR 5.0 p ¼ 0.009). A study from Singapore by Tan et al 48 retrospectively looked at complicated versus uncomplicated diabetes in ankle fractures. They found a significant difference in infection rate of 6% in uncomplicated and 50% in complicated diabetes.…”

Section: Discussionmentioning

confidence: 99%

Current concepts and challenges in managing ankle fractures in the presence of diabetes: A systematic review of the literature

Nash¹,

Hester

2021

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

Background: Ankle fractures in diabetic patients are known to have an increased morbidity. This systematic review aims to evaluate the current evidence in terms of risk profile and inform treatment options. Methods: Following the methodology of the Cochrane collaboration, an extensive literature search was conducted. Outcomes included, complications, operative and non-operative management and early weight-bearing. Results: A total of 40 studies were included. Complication rates were higher in diabetic patients and more so in poorly controlled diabetes, IDDM, or "complicated" diabetes. Supplementary fixation was associated with lower complication rates. Regarding early weight-bearing, similar results to nondiabetics in the stable fracture pattern were found providing there was no evidence of neuropathy. Conclusion: Diabetes, especially complicated diabetes, presents an increased risk of complications. However non operative management of diabetic ankle fractures do poorly, and with the use of 'ORIF plus' techniques there is no increase in complications from early fixation. The use of external fixation for definitive fixation should be minimised as it is associated with high complication rates.

show abstract

Infection Rates in Singaporeans with and without Complicated Diabetes after Ankle Fracture Surgery

Cited by 8 publications

References 13 publications

Incidence and risk factors for removal of an internal fixation following surgery for ankle fracture: A retrospective cohort study of 997 patients

Incidence and risk factors for removal of an internal fixation following surgery for ankle fracture: A retrospective cohort study of 997 patients

Chronic postoperative complications and donor site morbidity after sural nerve autograft harvest or biopsy

Current concepts and challenges in managing ankle fractures in the presence of diabetes: A systematic review of the literature

Contact Info

Product

Resources

About