THE OUTCOMES OF OPEN REDUCTION AND INTERNAL FIXATION OF ANKLE FRACTURES IN DIABETIC PATIENTS; A PROSPECTIVE SINGLE-ARM CLINICAL TRIAL.
Mohamed Salama Hamdy1, Yahia Mostafa Mohamed2, Abd El Aziz El Singergy1, Ashraf Abd El Kader El Nahal1 1Orthopedic Department, Cairo University, Cairo, Egypt.
2Orthopedic resident, Al Helal Hospital, Cairo, Egypt.
Purpose: Ankle fractures are common injuries that often require open reduction and internal fixation (ORIF) to restore stability and function. However, in diabetic patients, the risk of postoperative complications is heightened, necessitating a thorough understanding of treatment outcomes. This prospective cohort study aims to evaluate the efficacy and follow-up results of ORIF for ankle fractures in diabetic individuals, providing critical insights into optimizing care for this vulnerable population. Methods: This prospective interventional study included 32 diabetic patients presenting with closed ankle fractures at our hospital between January 2021 and January 2022. Participants underwent open reduction and internal fixation, followed by a six-month postoperative evaluation. We assessed surgical efficacy through radiological outcomes, the American Orthopaedic Foot and Ankle Score (AOFAS) ankle-hindfoot scale, the necessity for surgical revision, and the incidence of postoperative complications. Results: Union was achieved in 28.1% of patients, while 68.8% experienced delayed union and 71.8% developed infections. Notably, 87.5% of patients attained 'excellent' or 'good' ratings on the AOFAS ankle-hindfoot scale. Only a single patient necessitated surgical revision. Statistical analysis revealed a significant negative correlation between the AOFAS score and variables such as patient age, DM duration, fasting blood glucose levels, and DM complications (p<0.001). Furthermore, patients with delayed union had a longer mean DM duration and elevated fasting blood glucose compared to those achieving union (p<0.001). Conclusion: This study demonstrates a significant inverse relationship between the duration of DM and the fasting blood glucose levels to the AOFAS ankle-hindfoot scale scores. These factors were also markedly higher in patients who developed superficial infections or encountered delayed union.
June 2022