Journal of Musculoskeletal Trauma

Original Articles

Analysis of Clinical and Functional Outcomes according to the Blood Sugar Control Status at the Time of Ankle Fractures Resulting from Rotational Injuries: Jun Young Lee, Dong Seop Lim, Seung Hyun Lee, Seo Jin Park; J Korean Fract Soc 2022;35(4):135-141. Published online October 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.4.135

Abstract PDF: Purpose
Patients with diabetes are known to have poor clinical outcomes due to the high incidence of complications after ankle joint fracture surgery. This study reports the clinical and functional outcomes based on glycemic control status among patients with ankle joint fractures who underwent surgical treatment.
Materials and Methods
Among patients who underwent surgical treatment due to ankle joint fractures from January 2015 to October 2019, 253 patients with a minimum follow-up of 12 months were identified. We divided them into 3 groups: 195 patients with no diabetes (Group A), 26 patients with well-controlled diabetes (Group B), and 32 patients with uncontrolled diabetes (Group C). In addition, patients with lateral, medial malleolar, bimalleolar, and trimalleolar fractures were identified using radi-ography. The functional outcome measures used for evaluation were the Revised Foot Function Index (FFI), Short Musculoskeletal Function Assessment (SMFA), and the Foot and Ankle Outcome Score (FAOS).
Results
Bone union at 3 months after surgery was high in Group A, showing significant differences compared to the other groups. There was a significant difference between the groups in the incidence of arthropathy and one or more complications. However, the FFI, SMFA, and FAOS did not show significant differences between the groups.
Conclusion
The incidence of complications was high in patients with uncontrolled diabetes compared to the patients with well-controlled diabetes and those with no diabetes. However, functional outcomes showed no significant difference.

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Treatment of Intra-articular Calcaneal Fractures Using Minimally Invasive Sinus Tarsi Approach in Diabetic Patients: Hong Moon Sohn, Sang Ho Ha, Sang Hong Lee, Jun Young Lee, Jeong Ho Kim, Sang Jun Lee; J Korean Fract Soc 2008;21(3):195-199. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.195

PURPOSE
Wound problems occur in 5~30% of intra-articular calcaneal fractures following operation. Diabetes mellitus, large incisions and abundant dissection can increase the risk of wound problems that may require skin graft or other additional care. The authors used minimally invasive technique to treat intra-articular calcaneal fractures in diabetic patients and evaluated the results and complications of this method. MATERIALS AND METHODS: Between January 2002 and July 2005, 12 patients with intra-articular calcaneal fractures who had underlying diabetes mellitus were treated using minimally invasive technique with a modified sinus tarsi approach. The patients had an average age of 47 years (39~67) and were followed an average of 19 months (13~32). The mean period between injury and operation was 8 days (5~14). Crutch assisted partial weight bearing was advised for an average of 7.3 weeks (6~9) and full weight bearing was allowed after average of 9.3 weeks (7~11).
RESULTS
According to AOFAS scale for ankle and hindfoot, patients had the following results: excellent - 1 patient (8%), good - 9 patients (75%), fair - 1 patient (8%), unsatisfied - 1 patient (8%). Bone union was achieved in all cases and there were no events of deep infection or skin necrosis.
CONCLUSION
Treating intra-articular calcaneal fractures by minimally invasive technique is an excellent operative method for patients with diabetes mellitus, as this method can minimize soft tissue incision and resulting deep infection and skin necrosis.

Citations

Citations to this article as recorded by

Ankle and foot fracture management in patients with diabetes: an evidence-based review
Caroline E Plant, Arham Farukh Qureshi, Anna Chapman
Orthopaedics and Trauma.2026; 40(2): 105. CrossRef

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