• Dane K Wukich and Alex J Kline.
• University of Pittsburgh Medical Center Comprehensive Foot and Ankle Center, Roesch-Taylor Building, Suite 7300, 2100 Jane Street, Pittsburgh, PA 15203, USA. wukichdk@upmc.edu
• J Bone Joint Surg Am. 2008 Jul 1;90(7):1570-8.

AbstractPatients with diabetes mellitus have higher complication rates following both open and closed management of ankle fractures. Diabetic patients with neuropathy or vasculopathy have higher complication rates than both diabetic patients without these comorbidities and nondiabetic patients. Unstable ankle fractures in diabetic patients without neuropathy or vasculopathy are best treated with open reduction and internal fixation with use of standard techniques. Patients with neuropathy or vasculopathy are at increased risk for both soft-tissue and osseous complications, including delayed union and nonunion. Careful soft-tissue management as well as stable, rigid internal fixation are crucial to obtaining a good outcome. Prolonged non-weight-bearing and subsequently protected weight-bearing are recommended following both operative and nonoperative management of ankle fractures in patients with diabetes.

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