Navigation Links
Ankle Fracture Surgery – Diabetics fare worse than non-diabetics

A study at Duke Univ. has shown that the surgical outcome of surgery for fracture of ankle is not as good as in non-diabetics. The results were published Aug. 15, 2005, in the Journal of Bone and Joint Surgery.//

In the largest analysis of its kind, Duke University Medical Center researchers have found that patients with diabetes who require surgery for ankle fractures have significantly higher rates of complications and higher hospital costs compared to non-diabetic patients.

The researchers noted -

- Dabetics experienced one additional day of hospitalization (an average of 4.7 vs. 3.6 days) with costs approximately 20 percent higher ($12,898 vs. $10,794).
- Dabetics had higher mortality rates (0.26 percent vs. 0.11 percent)
- Hgher rates of post-operative complications (4.63 percent vs. 3.27 percent).

Ankle fractures are one of the most common injuries treated by orthopedic surgeons, and the study's findings provide guidance on how to improve the care for these patients and reduce health care expenditures.

"While a number of smaller studies have indicated that diabetic patients tended to have worse outcomes after ankle surgery, this is the first large-scale analysis of a cross-section of patients across the U.S.," said Shanti Ganesh, M.P.H., lead author of the study and fourth-year year medical student at Duke University School of Medicine.

"This analysis demonstrated that diabetic patients, no matter how severe the ankle fracture, were more likely to experience higher rates of post-operative complications, mortality, and non-routine discharge, with accompanying longer lengths of hospital stay and higher hospital charges," Ganesh said.

For their analysis, the Duke team consulted the Nationwide Inpatient Samples (NIS) database and identified 169,598 patients who underwent surgery for ankle fractures. The NIS, sponsored by the U.S. Agency for Healthcare Research and Quali ty, is a publicly available database of more than 8 million patients from more than 1,000 U.S. hospitals. The hospitals vary by region, size, location, teaching status and ownership.

"The strength of this analysis is that it provides a nationally representative and real-world picture of what happens to ankle fracture patients in the U.S.," said Ricardo Pietrobon, M.D., senior member of the research team and director of Duke's Center for Excellence in Surgical Outcomes (CESO), which supported the analysis. "We were unable to extrapolate from the data gathered from smaller, single-center studies what the situation was nationwide.

"Now we have specific data that allows us to quantify the added risks and costs of diabetes for these patients," Pietrobon continued. "This information is crucial in improving outcomes and quality of life for our patients undergoing surgery to repair ankle fractures."

Of the 169,598 ankle fracture patients, the Duke team identified 9,174 (5.71 percent) with diabetes. The diabetic patients tended to be more than 10 years older than the non-diabetic patients, and when they did suffer ankle fractures, they tended to be more severe than those suffered by non-diabetic patients.

Ganesh said that the results of the study indicate that physicians taking care of ankle fracture patients should appreciate the effect that diabetes can have on the treatment and recovery of their patients. Strategies could include

- Close monitoring of glucose levels during and after surgery
- Prevent the formation of deep venous thrombosis (DVT), which can occur in surgery patients who are bedridden for extended periods of time.

It is also widely appreciated that diabetic patients tend to have slower healing rates than non-diabetic patients, Ganesh continued. This can be important not only during hospitalization, but also after discharge, when patients typically begin rehabilitation activities, she added.

One interesting finding, which the researchers said was not a focus of the current study and confirms other findings, was that the percentage of patients with diabetes steadily increased over the 12-year period from 1988 to 2000.

The researchers estimate that of the 260,000 Americans who fracture their ankles every year, about 25 percent will require surgery to stabilize the ankle.

Other Duke members of the team, in addition to Ganesh and Pietrobon, were Deng Pan, Nina Lightdale, M.D. and James Nunley, M.D. William Cecilio, Catholic University of Parana, Brazil, was also a member of the team.

There has been an increase in the number of diabetics in India and it is estimated that in the next 10 years this is likely to be the next epidemic in the country. This study should be looked at carefully by the India Orthopedic team and they shoul;d look at thioer results in fracture of the ankle surgery.

Contact: Richard Merritt
Merri006@mc.duke.edu
919-684-4148
Duke University Medical Center

'"/>




Related medicine news :

1. Arthroscopy for Ankles
2. MRI of the Ankle Changes Patient Treatment And Improves Diagnosis
3. Jaya Cracked Ankle at Drona Sets
4. Drug Found Effective In Reducing Vertebral Fractures In Women
5. Reducing The Risk Of Fractures After a Heart Transplant
6. Treatment For Prostate Cancer Found To Increases Fracture Risk
7. Reducing Vertebral Fractures In Women
8. Androgen Deprivation Therapy For Prostate Cancer Found To Increase The Risk Of Fractures
9. Folic Acid and Vitamin B12 Effective In Reducing The Risk Of Hip Fracture After Stroke
10. Calcium-Vitamin D Combo For Reduced Fracture Risk
11. A Closer Look into Vitamin D and Fractures
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:6/25/2016)... Beach, CA (PRWEB) , ... June 25, 2016 , ... ... UCLA with Magna Cum Laude and his M.D from the David Geffen School of ... Diego and returned to Los Angeles to complete his fellowship in hematology/oncology at the ...
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, ... Bronze Wellness at Work award to iHire in recognition of their exemplary accomplishments in ... the 7th annual Maryland Workplace Health & Wellness Symposium at the BWI Marriott in ...
(Date:6/24/2016)... ... June 24, 2016 , ... A recent article published June 14 ... The article goes on to state that individuals are now more comfortable seeking to ... operations such as calf and cheek reduction. The Los Angeles area medical group, Beverly ...
(Date:6/24/2016)... ... , ... June 19, 2016 is World Sickle Cell Observance Day. In an ... of holistic treatments, Serenity Recovery Center of Marne, Michigan, has issued a ... Cell Disease (SCD) is a disorder of the red blood cells, which can cause ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... Scientific Sessions in Dallas that it will receive two significant new grants to ... came as PHA marked its 25th anniversary by recognizing patients, medical professionals and ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... CAMBRIDGE, Mass. , June 24, 2016 /PRNewswire/ ... the Spaulding Rehabilitation Network,s Dean Center for ... of Physical Medicine and Rehabilitation, MIT Hacking Medicine, ... Center for Innovation, today announced the five finalists ... Hackathon for Lyme disease.  More than 100 scientists, ...
(Date:6/24/2016)... DUBLIN , June 24, 2016 ... addition of the "Structural Electronics 2015-2025: Applications, ... In-Mold Electronics, Smart ... Integrated Photovoltaics Structural electronics involves ... as load-bearing, protective structures, replacing dumb structures such ...
(Date:6/24/2016)... Dehaier Medical Systems Ltd. (NASDAQ: ... and sells medical devices and wearable sleep respiratory products ... cooperation agreement with Hongyuan Supply Chain Management Co., Ltd. ... 20, 2016, to develop Dehaier,s new Internet medical technology ... will leverage Hongyuan Supply Chain,s sales platform to reach ...
Breaking Medicine Technology: