Essential Pearls On Treating Diabetic Ankle Fractures

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Keith D. Cook, DPM, FACFAS, Carl Brandon Lindberg, DPM, and Joseph Genualdi, DPM

1. Flynn JM, Rodriquez-del Rio F, Piza PA. Closed ankle fractures in the diabetic patient. Foot Ankle Int. 2000;21(4):311–9.
2. Gandhi A, Liporace F, Azad V, et al. Diabetic fracture healing. Foot Ankle Clin. 2006;11(4):805-24
3. Schon LC, Easley ME, Weinfeld SB. Charcot neuroarthropathy of the foot and ankle. Clin Orthop Relat Res. 1998;349:116-31
4. Lillmars SA, Meister BR. Acute trauma to the diabetic foot and ankle. Curr Opin Orthop. 2001;12(2):100-105.
5. Ganesh SP, Pietrobron R, Cecilio WA, et al. The impact of diabetes on patient outcomes after ankle fracture. J Bone Joint Surg Am. 2005;87(8):1712-1718.
6. Boddenberg U. Healing time of foot and ankle fractures in patients with diabetes mellitus: literature review and report on own cases. Zentralbl Chir. 2004;129(6):453-9.
7. Loder R. The influence of diabetes mellitus on the healing of closed fractures. Clin Orthop. 1988;232:210–216
8. Cozen L. Does diabetes delay fracture healing? Clin Orthop. 1972; 82:134–140.
9. Lu H, Kraut D, Gerstenfield LC, Graves DT. Diabetes interferes with the bone formation by affecting the expression of transcription factors that regulate osteoblast differentiation. Endocrinology. 2003; 144(1):346-52.
10. Kayal RA, Tsatsas D, Bauer MA, et al. Diminished bone formation during diabetic fracture healing is related to the premature resorption of cartilage associated with increased osteoclast activity. J Bone Miner Res. 2007; 22(4):560–568.
11. Bibbo C, Lin SS, Beam HA, Behrens FF. Complications of ankle fractures in
diabetic patients. Orthop Clin North Am. 2001;32(1):113-33.
12. Jones KB, Maiers-Yelden KA, Marsh JL, et al. Ankle fractures in patients with diabetes mellitus. J Bone Joint Surg. 2005; 87(4):489-495.
13. Costigan W, Thordarson DB, Debnath UK. Operative management of ankle fractures in patients with diabetes mellitus. Foot Ankle Int. 2007;28(1):32-7.
14. Liu J, Ludwig T, Ebraheim NA. Effects of the blood HbA1c on surgical treatment outcomes of diabetics with ankle fractures. Orthop Surg. 2013 Aug;5(3):203-8.
15. Hoogwerf BJ, Sferra J, Donley BG. Diabetes mellitus –overview. Foot Ankle Clin. 2006;11(4):703-15.
16. Dellenbaugh SG, DiPreta JA, Uhl RL. Treatment of ankle fractures in patients with diabetes. Orthopedics. 2011 May;34(5):383-388
17. Wukich D, Kline A. The management of ankle fractures in patients with diabetes. J Bone Joint Surg Am 2008;90(7):1570-8
18. Blotter RH, Connolly E, Wasan A, Chapman MW. Acute complications in the operative treatment of isolated ankle fractures in patients with diabetes mellitus. Foot Ankle Int. 1999;20(11):687-94.
19. Johnson JE. Operative treatment of neuropathic arthropathy of the foot andankle. J Bone Joint Surg Am. 1998;80(6):1700-9.
20. Miranda M. Locking plate technology and its role in osteoporotic fractures injury. Injury, 2007; 38(Suppl 3):S35–S39.
21. Jani MM, Ricci WM, Borrelli J Jr., et al. A protocol for treatment of unstable ankle fractures using transarticular fixation in patients with diabetes mellitus and loss of protective sensibility. Foot Ankle Int. 2003;24(11):838-44.
22. Perry MD, Taranow WS, Manoli A 2d, Carr JB. Salvage of failed neuropathic ankle fractures: use of large-fragment fibular plating and multiple syndesmotic screws. J Surg Orthop Adv. 2005;14(2):85-91.
23. Schon LC, Marks RM. The management of neuroarthropathic fracture dislocations in the diabetic patient. Orthop Clin North Am. 1995;26(2):375-92.

   Editor’s note: For a related article, see “Current Insights On Treating Ankle Fractures In Patients With Diabetes” in the June 2013 issue of Podiatry Today or visit the archives at .

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