Outcome In Ankle Fractures In Diabetic Vs Non- Diabetics

Background: Ankle fractures in diabetic patients have always been considered difficult injuries and previous studies in this field showed that the incidence of complication can be in the range of 32%3 to 42.3%6. Aims: The aim of this study was to assess the outcome in ankle fractures in diabetic population and to find out reasons for any results contrary to previous studies. Methods: We performed a case control study comparing a group of 24 diabetic patients, with ankle fractures, with a group of 48 non-diabetic patients demographically similar for age, gender, type of injury, treatment provide and length of follow-up. In diabetic group 9 were treated conservatively and 15 had ORIF while in non-diabetic group 16 were treated conservatively and 32 underwent operative treatment. The diabetic and non-diabetic groups were followed up for mean periods of 50.3 months and 43.1 months respectively and on the conclusion of the study a clinic was arranged in April 2003 and the outcome was assessed according to the 100 point Maryland foot score. Results: In the diabetic group 4 patients while in the non-diabetic group 7 patients developed complications. None of the 72 patients in this study required further surgery. The mean Maryland foot score of diabetic group was 95.08 and that of nondiabetic group was 93.79. Conclusion: Our study shows that in the presence of optimal control of diabetes mellitus and careful patient selection for type of treatment, these lesions can result in an outcome comparable to non-diabetic patients with similar injuries (p = 0.086).