The Impact of Diabetes on Patient Outcomes After Ankle Fracture

Abstract

This nationally representative study of inpatients in the United States provides evidence that diabetic patients with an operatively treated ankle fracture are likely to have worse results than non-diabetic patients with regard to postoperative complications, mortality, rate of non-routine discharge, length of hospital stay, and total hospital charges.

Complications after Ankle Fracture in Elderly Patients

“…Based on fracture type, 7.6% (2,570) of patients sustained an isolated medial malleolar fracture, 50.8% (17,136) an isolated lateral malleolar fracture, 27.5% (9,214) a bimalleolar fracture, and 14.2% (4,784) a trimalleolar fracture. Thirty-three percent (11,154) of patients were treated operatively. Patients whose fractures were treated operatively were younger, had fewer medical comorbidities based on the Charlson index, and were less likely to have had diabetes or peripheral vascular disease.…”

The Impact of Smoking on Complications After Operatively Treated Ankle Fractures—A Follow-Up Study of 906 Patients

“…5 Factors shown to be associated with an increased risk of postoperative complications include complex fractures, open injuries, diabetes, peripheral vascular disease, female sex, old age, medical comorbidities, alcohol abuse, and delay of surgery. [4][5][6][7][8][9][10][11] Furthermore, the function of the ankle is known to be negatively affected by poor operative reduction. 12,13 Even ankle fractures that have healed uneventfully have been shown to negatively affect functional outcome in a substantial proportion of patients.…”

Diabetic Fracture Healing

“…Those patients with diabetes had a significantly greater in-hospital mortality, rate of in-hospital postoperative complications, length of hospital stay, total charges, and rate of nonroutine discharge. This held true for all levels of fracture severity (closed, unimalleolar, closed bimalleolar or trimalleolar, and dislocated or open fractures) [60].…”

“…Patients with diabetes have been shown to have an increased rate of sustaining more severe ankle fractures than patients without diabetes (Fig. 3.) [60].…”