Open ankle fractures in patients with diabetes mellitus

Complications after surgical treatment of closed ankle fractures in patients with diabetes previously have been well documented. The purpose of this study was to evaluate the union rate, infection rate, and soft tissue complication rate in open ankle fractures in patients with diabetes. Between January 1, 1981 and December 31, 2000,14 open ankle fractures in 13 patients with diabetes were treated. The mean followup was 19 months (range, 6-84 months). All patients were followed up until union, amputation, or for at least 6 months. Nine of 14 extremities (64%) had wound healing complications. Ultimately, five patients (six extremities; 42%) had below-knee amputation. Only three of 14 fractures in three patients healed without complications. Open ankle fractures in patients with diabetes are limb-threatening injuries with high amputation and infection rates despite contemporary techniques of open reduction and internal fixation, intravenous antibiotics, and emergent irrigation and debridement.