Wukich Dane K, Belczyk Ronald J, Burns Patrick R, Frykberg Robert G
UPMC Comprehensive Foot and Ankle Center, Roesch-Taylor Bldg., 2100 Jane St., Ste 7300, Pittsburgh, PA, 15203, USA.
Foot Ankle Int. 2008 Oct;29(10):994-1000. doi: 10.3113/FAI.2008.0994.
The purpose of this study was to identify and report the complications associated with the use of circular ring fixation in diabetic patients, and to compare the frequency of complications in patients without diabetes. We hypothesized that complications with circular ring fixation occurred more frequently in patients with diabetes than patients without diabetes.
Institutional Review Board approval was obtained and patient charts were retrospectively reviewed from June 2004 and February 2007. Fifty six consecutive patients undergoing midfoot, hindfoot and/or ankle surgery were treated with circular ring fixation which included 33 diabetic patients in the study group and 23 non-diabetic patients in the control group. Patient demographics, the duration of treatment with the external fixator, and complications were recorded.
Males had a greater number of complications compared to females (p = 0.0014). The total number of complications was statistically greater in diabetic patients (study group) versus non-diabetic patients (control group) (p = 0.003). In multivariate logistic regression, diabetes and male sex were the only significant variables associated with wire complications (OR 7.35, 95% CI 1.93-28.04 and OR 0.22, 95% CI 0.05-8584111, respectively).
Women are protected from wire complications with a risk reduction of 78% compared to males. Diabetics have a 7-fold risk for any wire complication compared to patients without diabetes. We found no adverse effects of BMI, obesity, age, smoking, neuropathy, or Charcot neuroarthropathy on a satisfactory recovery.
本研究的目的是识别并报告糖尿病患者使用环形外固定架的相关并发症，并比较无糖尿病患者的并发症发生率。我们假设糖尿病患者使用环形外固定架发生并发症的频率高于无糖尿病患者。
获得机构审查委员会批准，对2004年6月至2007年2月的患者病历进行回顾性研究。连续56例接受中足、后足和/或踝关节手术的患者采用环形外固定架治疗，其中研究组33例糖尿病患者，对照组23例非糖尿病患者。记录患者人口统计学资料、外固定架治疗时间及并发症情况。
男性并发症数量多于女性（p = 0.0014）。糖尿病患者（研究组）的并发症总数在统计学上高于非糖尿病患者（对照组）（p = 0.003）。在多因素逻辑回归分析中，糖尿病和男性性别是与钢丝相关并发症唯一显著相关的变量（比值比分别为7.35，95%可信区间1.93 - 28.04；以及比值比0.22，95%可信区间0.05 - 8584111）。
与男性相比，女性发生钢丝相关并发症的风险降低78%。与无糖尿病患者相比，糖尿病患者发生任何钢丝相关并发症的风险高出7倍。我们未发现体重指数、肥胖、年龄、吸烟、神经病变或夏科氏神经关节病对满意恢复有不良影响。
