Evaluating the potential advantages offered by primary fusion in patients with complicated diabetes mellitus presenting with an ankle fracture: A case report
Keywords:ankle ORIF, ankle fusion, ankle fusion diabetes, lower extremity, foot and ankle surgery, TTC nail
Ankle fractures make up nine percent of all adult fractures and over 260,000 ankle fractures are diagnosed annually in the United States. These injuries range from low-energy rotational injuries to severe fractures with significant dislocations with soft tissue compromise. Approximately 25 percent of all ankle fractures are treated with surgical intervention. Approximately, one eighth of these fractures occur in diabetic patients, a number which continues to increase as the prevalence of diabetes increases. This case report delves into the surgical management of an acute ankle fracture in a 54-year-old female with multiple medical comorbidities including diabetes mellitus with peripheral neuropathy, PVD, ESRD, status-post kidney transplant on dialysis, history of DVT on warfarin. Patient was definitively managed with an ankle and subtalar joint fusion, which has been shown to be an effective treatment option for diabetic patients with an acute ankle fracture.
Genovese N, Patel J, Lin SS, Greendyk J. Primary Tibiotalocalcaneal Fusion for High-risk Complex Ankle Fractures. J Foot Ankle Surg (Asia Pac). 2021;8(4):189.
Dellenbaugh SG, DiPreta JA, Uhl RL. Treatment of ankle fractures in patients with diabetes. Orthopedics. 2011;34(5):383-388.
Vaudreuil NJ, Fourman MS, Wukich DK. Limb salvage after failed initial operative management of bimalleolar ankle fractures in diabetic neuropathy. Foot Ankle Int. 2017;38(3):248-254.
Ebaugh MP, Umbel B, Goss D, Taylor BC. Outcomes of primary tibiotalocalcaneal nailing for complicated diabetic ankle fractures. Foot Ankle Int. 2019;40(12):1382-1387.
Wallace SJ, Liskutin TE, Schiff AP, Pinzur MS. Ankle fusion following failed initial treatment of complex ankle fractures in neuropathic diabetics. Foot Ankle Surg. 2020;26(2):189-192.
Wukich DK, Shen JY, Ramirez CP, Irrgang JJ. Retrograde ankle arthrodesis using an intramedullary nail: a comparison of patients with and without diabetes mellitus. J Foot Ankle Surg. 2011;50(3):299-306.
Ayoub MA. Ankle fractures in diabetic neuropathic arthropathy: can tibiotalar arthrodesis salvage the limb? J Bone Joint Surg Br. 2008;90(7):906-914.
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