Wukich Dane K
Dane K Wukich, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, UPMC Mercy Health Center, Pittsburgh, PA 15219, United States.
World J Orthop. 2015 Apr 18;6(3):331-9. doi: 10.5312/wjo.v6.i3.331.
An estimated 285 million adults (aged 20-79 years) worldwide were diagnosed to have diabetes mellitus (DM) in 2010, and this number is projected to grow to 439 million adults by the year 2030. Orthopaedic surgeons, regardless of their subspecialty interest, will encounter patients with DM during their career since this epidemic involves both developed and emerging countries. Diabetes results in complications affecting multiple organ systems, potentially resulting in adverse outcomes after orthopaedic surgery. The purpose of this review is to discuss the pathophysiology of DM and its potential for impacting orthopaedic surgery patients. Diabetes adversely affects the outcome of all orthopaedic surgery subspecialties including foot and ankle, upper extremity, adult reconstructive, pediatrics, spine surgery and sports medicine. Poorly controlled diabetes negatively impacts bone, soft tissue, ligament and tendon healing. It is the complications of diabetes such as neuropathy, peripheral artery disease, and end stage renal disease which contributes to adverse outcomes. Well controlled diabetic patients without comorbidities have similar outcomes to patients without diabetes. Orthopaedic surgeons should utilize consultants who will assist in inpatient glycemic management as well as optimizing long term glycemic control.
2010年，全球估计有2.85亿成年人（年龄在20 - 79岁之间）被诊断患有糖尿病，预计到2030年，这一数字将增至4.39亿成年人。骨科医生，无论其亚专业兴趣如何，在其职业生涯中都会遇到糖尿病患者，因为这种流行病在发达国家和新兴国家都存在。糖尿病会引发影响多个器官系统的并发症，可能导致骨科手术后出现不良后果。本综述的目的是讨论糖尿病的病理生理学及其对骨科手术患者的潜在影响。糖尿病对所有骨科手术亚专业的结果都有不利影响，包括足踝、上肢、成人重建、儿科、脊柱手术和运动医学。血糖控制不佳会对骨骼、软组织、韧带和肌腱的愈合产生负面影响。糖尿病的并发症，如神经病变、外周动脉疾病和终末期肾病，是导致不良后果的原因。血糖控制良好且无合并症的糖尿病患者与非糖尿病患者的结果相似。骨科医生应利用顾问协助住院患者的血糖管理以及优化长期血糖控制。
