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Fluoroscopy-guided reduction and fibular nail fixation to manage unstable ankle fractures in patients with diabetes

Authors :
Ashman, B. D.
Kong, C.
Wing, K. J.
Penner, M. J.
Bugler, K. E.
White, T. O.
Younger, A. S. E.
Source :
The Bone & Joint Journal; September 2016, Vol. 98 Issue: 9 p1197-1201, 5p
Publication Year :
2016

Abstract

AimsPatients with diabetes are at increased risk of wound complications after open reduction and internal fixation of unstable ankle fractures. A fibular nail avoids large surgical incisions and allows anatomical reduction of the mortise.Patients and MethodsWe retrospectively reviewed the results of fluoroscopy-guided reduction and percutaneous fibular nail fixation for unstable Weber type B or C fractures in 24 adult patients with type 1 or type 2 diabetes. The re-operation rate for wound dehiscence or other indications such as amputation, mortality and functional outcomes was determined.ResultsTwo patients developed lateral side wound infection, one of whom underwent wound debridement. Three other patients required re-operation for removal of symptomatic hardware. No patient required a below-knee amputation. Six patients died during the study period for unrelated reasons. At a median follow-up of 12 months (7 to 38) the mean Short Form-36 Mental Component Score and Physical Component Score were 53.2 (95% confidence intervals (CI) 48.1 to 58.4) and 39.3 (95% CI 32.1 to 46.4), respectively. The mean Visual Analogue Score for pain was 3.1 (95% 1.4 to 4.9). The mean Ankle Osteoarthritis Scale total score was 32.9 (95% CI 16.0 to 49.7).ConclusionFluoroscopy-guided reduction and fibular nail fixation of unstable ankle fractures in patients with diabetes was associated with a low incidence of wound and overall complications, while providing effective surgical fixation.Cite this article: Bone Joint J2016;98-B:1197–1201.

Details

Language :
English
ISSN :
20494394 and 20494408
Volume :
98
Issue :
9
Database :
Supplemental Index
Journal :
The Bone & Joint Journal
Publication Type :
Periodical
Accession number :
ejs39920162
Full Text :
https://doi.org/10.1302/0301-620X.98B9.37140