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J Foot Ankle Surg. 2013 Mar-Apr;52(2):207-11. doi: 10.1053/j.jfas.2012.11.012. Epub 2013 Jan 11.

Factors associated with nonunion, delayed union, and malunion in foot and ankle surgery in diabetic patients.

Author information

1
Department of Surgery, Texas A&M Health and Science Center College of Medicine, Temple, TX, USA. shibuya@medicine.tamhsc.edu

Abstract

The incidence of bone healing complications in diabetic patients is believed to be high after foot and ankle surgery. Although the association of hyperglycemia with bone healing complications has been well documented, little clinical information is available to show which diabetes-related comorbidities directly affect bone healing. Our goal was to better understand the risk factors associated with poor bone healing in the diabetic population through an exploratory, observational, retrospective, cohort study. To this end, 165 diabetic patients who had undergone arthrodesis, osteotomy, or fracture reduction were enrolled in the study to assess the risk factors associated with nonunion, delayed union, and malunion after elective and nonelective foot and/or ankle surgery. Bivariate analyses showed that a history of foot ulcer, peripheral neuropathy, and surgery duration were statistically significantly associated with bone healing complications. After adjusting for other covariates, only peripheral neuropathy, surgery duration, and hemoglobin A1c levels >7% were significantly associated statistically with bone healing complications. Of the risk factors we considered, peripheral neuropathy had the strongest association with bone healing complications.

PMID:
23313498
DOI:
10.1053/j.jfas.2012.11.012
[Indexed for MEDLINE]

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