Complications of ankle fractures in diabetic patients

Ankle fractures in patients with diabetes have long been recognized as a challenge to clinicians in terms of delays in fracture healing, difficulties with wound healing, and the development of Charcot arthropathy. Significant controversy exists as to whether ankle fractures in diabetic patients are best treated conservatively (closed methods) or by open reduction and internal fixation. Despite these well-known management difficulties of ankle fractures in patients with diabetes mellitus, clinical series reporting on the results of treatment of patients with ankle fractures and diabetes mellitus are few. Several complications in the care of ankle fractures in patients with diabetes mellitus are presented, emphasizing the basic science behind the pathogenesis of these management challenges. In addition, clinical recommendations for the management of ankle fractures in diabetic patients, in reference to these complications, are presented.