Ankle and hindfoot fusions: Comparison of outcomes in patients with and without diabetes

Thomas G. Myers, Nicholas J. Lowery, Robert G. Frykberg, Dane K. Wukich

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Background: Patients with diabetes mellitus (DM) are believed to have higher complication rates when undergoing ankle and hindfoot fusions, but data is lacking. The purpose of this study was to compare the postoperative outcomes of major foot and ankle arthrodeses in patients with and without DM. Another goal was to evaluate what effect glycemic control had on the outcomes of patients with diabetes. Methods: A retrospective review of charts from operative years 2005 to 2010 was performed. Inclusion criteria encompassed patients requiring major hindfoot and/or ankle fusion. Exclusion criteria included any patient who did not have at least 6-month followup. Seventy four patients with DM were matched with 74 non-DM patients based on age, gender, and length of surgery. Significance was set at p < 0.05 with associated 95% confidence intervals. Results: The overall complication rate was found to be significantly higher in patients with DM, a history of tobacco use, and peripheral neuropathy. The postoperative infection rate was found to be significantly higher in patients with DM, poor longterm glucose control (Hgb A1c levels greater than or equal to 7%), a history of tobacco use, peripheral artery disease, and peripheral neuropathy. Our rate of noninfectious complications was found to be significantly higher in patients with DM, poor short-term glucose control (a preoperative glucose greater than 200 mg/dL), a history of tobacco use, and previous solid organ transplantation. Patients greater than or equal to 65 years of age were significantly associated with fewer overall complications and postoperative infections. Conclusion: This study confirmed our hypothesis that patients with DM were at increased risk for postoperative complications after foot and/or ankle arthrodesis when compared to patients without DM. A secondary finding of this study demonstrated patients with poor short- and long-term glucose control experienced more complications.

Original languageEnglish (US)
Pages (from-to)20-28
Number of pages9
JournalFoot and Ankle International
Volume33
Issue number1
DOIs
StatePublished - Jan 1 2012

Fingerprint

Ankle
Diabetes Mellitus
Tobacco Use
Glucose
Arthrodesis
Peripheral Nervous System Diseases
Foot
Peripheral Arterial Disease
Organ Transplantation
Infection
Confidence Intervals

Keywords

  • Ankle fusions
  • Diabetic complications
  • Diabetic fusions
  • Hindfoot fusions
  • Postoperative complications

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Ankle and hindfoot fusions : Comparison of outcomes in patients with and without diabetes. / Myers, Thomas G.; Lowery, Nicholas J.; Frykberg, Robert G.; Wukich, Dane K.

In: Foot and Ankle International, Vol. 33, No. 1, 01.01.2012, p. 20-28.

Research output: Contribution to journalArticle

Myers, Thomas G. ; Lowery, Nicholas J. ; Frykberg, Robert G. ; Wukich, Dane K. / Ankle and hindfoot fusions : Comparison of outcomes in patients with and without diabetes. In: Foot and Ankle International. 2012 ; Vol. 33, No. 1. pp. 20-28.
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