Manway Jeffrey M, Blazek Cody D, Burns Patrick R
UPMC Department of Orthopaedic Surgery, Division of Foot and Ankle Surgery, 600 Oxford Dr, Monroeville, PA, 15146, USA.
UPMC Mercy Podiatric Surgical Residency, Pittsburgh, PA, USA.
Curr Rev Musculoskelet Med. 2018 Sep;11(3):445-455. doi: 10.1007/s12178-018-9508-x.
Ankle fractures and diabetes mellitus are both increasing in prevalence. Patients with both diabetes and an ankle fracture have been shown to have an increased rate of complications which can be catastrophic. The purposes of this review are to identify factors placing patients at an increased risk and offer guidance on the management of these injuries, in order to reduce potential complications.
Non-operative management of unstable ankle fractures in patients with diabetes results in an unacceptably high rate of complications. Operatively managed patients with uncomplicated diabetes seem to fair as well as patients without diabetes. Thus, it is important to recognize patients as either complicated or uncomplicated at the onset of their treatment based on comorbidities. There is limited evidence to guide the management of ankle fractures in patients with diabetes, in particular those deemed complicated. Non-operative management of unstable fractures in diabetic patients should be avoided.
踝关节骨折和糖尿病的患病率均在上升。患有糖尿病和踝关节骨折的患者并发症发生率增加，这可能是灾难性的。本综述的目的是确定使患者风险增加的因素，并为这些损伤的管理提供指导，以减少潜在并发症。
糖尿病患者不稳定踝关节骨折的非手术治疗导致并发症发生率高得令人无法接受。手术治疗的无并发症糖尿病患者似乎与无糖尿病患者情况相同。因此，在治疗开始时根据合并症将患者识别为复杂或非复杂很重要。指导糖尿病患者踝关节骨折管理的证据有限，尤其是那些被认为复杂的患者。应避免对糖尿病患者的不稳定骨折进行非手术治疗。
