TY - JOUR
T1 - Post-operative outcomes of talus fracture open reduction internal fixation in patients with diabetes mellitus
AU - Conover, Benjamin M.
AU - Johnson, Matthew J.
AU - Frykberg, Robert G.
AU - Raspovic, Katherine M.
AU - Wukich, Dane K.
N1 - Publisher Copyright:
© 2024 the American College of Foot and Ankle Surgeons
PY - 2025/1/1
Y1 - 2025/1/1
N2 - Little is known regarding outcomes of talus fracture management among patients with diabetes mellitus. This study aimed to compare post-operative outcomes after open reduction and internal fixation for talus fracture in patients with complicated diabetes, uncomplicated diabetes, and patients without diabetes. We used the PearlDiver database to identify patients who underwent operative repair of talus fractures from 2009 to 2021. Complications were evaluated at 30-days, 90-days, and 1 year of surgery. As we performed multiple separate analyses, to minimize the risk of type 1 error we employed the Bonferroni correction for statistical significance (p< 0.017). The PearlDiver identified 5,232 patients with talus fracture that underwent open reduction internal fixation. Stratified by diabetes status, the “complicated diabetes,” “uncomplicated diabetes,” and “no diabetes” groups contained 223, 418, and 4591 patients, respectively. Reoperation, acute kidney injury, and myocardial infarction were increased among diabetes patients compared to non-diabetes patients, irrespective of diabetes severity within 3 months of surgery. Furthermore, patients with complicated diabetes were more likely to develop sepsis and wound disruption compared to their non-diabetes counterparts within 3 months. While not statistically significant, complicated diabetes patients were diagnosed with talar non-union at higher rates compared with non-diabetes patients. Further analysis may reveal a clinically significant discrepancy in non-union between these groups. Complicated diabetes is associated with significantly higher risk of multiple adverse events following talus fracture repair.
AB - Little is known regarding outcomes of talus fracture management among patients with diabetes mellitus. This study aimed to compare post-operative outcomes after open reduction and internal fixation for talus fracture in patients with complicated diabetes, uncomplicated diabetes, and patients without diabetes. We used the PearlDiver database to identify patients who underwent operative repair of talus fractures from 2009 to 2021. Complications were evaluated at 30-days, 90-days, and 1 year of surgery. As we performed multiple separate analyses, to minimize the risk of type 1 error we employed the Bonferroni correction for statistical significance (p< 0.017). The PearlDiver identified 5,232 patients with talus fracture that underwent open reduction internal fixation. Stratified by diabetes status, the “complicated diabetes,” “uncomplicated diabetes,” and “no diabetes” groups contained 223, 418, and 4591 patients, respectively. Reoperation, acute kidney injury, and myocardial infarction were increased among diabetes patients compared to non-diabetes patients, irrespective of diabetes severity within 3 months of surgery. Furthermore, patients with complicated diabetes were more likely to develop sepsis and wound disruption compared to their non-diabetes counterparts within 3 months. While not statistically significant, complicated diabetes patients were diagnosed with talar non-union at higher rates compared with non-diabetes patients. Further analysis may reveal a clinically significant discrepancy in non-union between these groups. Complicated diabetes is associated with significantly higher risk of multiple adverse events following talus fracture repair.
KW - 3
KW - Complications
KW - Diabetic foot
KW - Orthopedic
KW - Surgery
KW - Trauma
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UR - http://www.scopus.com/inward/citedby.url?scp=85204361103&partnerID=8YFLogxK
U2 - 10.1053/j.jfas.2024.09.003
DO - 10.1053/j.jfas.2024.09.003
M3 - Article
C2 - 39288843
AN - SCOPUS:85204361103
SN - 1067-2516
VL - 64
SP - 61
EP - 66
JO - Journal of Foot and Ankle Surgery
JF - Journal of Foot and Ankle Surgery
IS - 1
ER -