Risk Factors for Charcot Arthropathy After Diabetic Ankle Fracture Surgery
Objective To evaluate the outcome of surgical treatment for diabetic ankle fractures and analyze the risk factors for postoperative Charcot neuroarthropathy(CNO).Methods A retrospective analysis was performed on 127 patients with unilateral diabetes mellitus(DM)ankle fractures who were treated with open reduction and internal fixation in Foshan Hospital of Traditional Chinese Medicine from January 2019 to June 2023 and met the selection criteria.There were 73 males and 54 females with an average age of(61.7±8.6)years old,ranging from 39 to 79 years old.Fracture healing was evaluated by follow-up X-rays,and the Baird-Jackson ankle score was used to evaluate clinical efficacy.The incidence of complications during the follow-up period was recorded,and the risk factors for postoperative CNO were analyzed.Results Postoperatively,23 cases had superficial infection and delayed healing of the incision,3 cases had deep infection,and the incisions of the remaining patients healed by primary intention.The follow-up time was 7～19 months,with an average of(12.2±3.5)months.109 cases healed successfully,25 cases had delayed healing,with an average healing time of(3.4±0.5)months;18 cases had nonunion,and 9 cases had internal fixation fracture;12 cases had CNO,and 115 cases did not have CNO.In terms of clinical efficacy,89 cases were excellent,12 cases were good,8 cases were fair,and 18 cases were poor,with an excellent and good rate of 79.5％.Univariate analysis showed that there were significant differences in DM course,peripheral neuropathy,glycosylated hemoglobin level and chronic complications of DM between the two groups;further logistic regression analysis showed that peripheral neuropathy and chronic complications of DM were risk factors for CNO after DM ankle fracture surgery.Conclusion The overall outcome of surgical treatment for diabetic ankle fractures is satisfactory;however,the incidence of postoperative complications is high.The risk of CNO increases when there is a concomitant presence of diabetic peripheral neuropathy and chronic diabetes complications.
万方数据
维普
