Question:My wife fell and broke her left ankle last weekend. She happens to be a diabetic, so the medical team read us a long list of things that could happen. Good grief -- why scare her with all the things that could happen before they do? There's no sense in borrowing trouble. Was this really necessary?
Answer:Many physicians believe that it's important for fracture patients who also have diabetes to be aware of the potential problems that can occur. Every effort must be made to avoid the kinds of serious complications that can develop in this group of patients.
Diabetes affects the blood vessels and nerves of the hands and feet. With less than normal supply of oxygen, nutrients, and nerve messages, there's a big risk of delayed healing. It's even possible that healing won't occur at all.
You probably heard the list of possible problems: infection, nonunion, malunion, and destruction of the joint. Any of these can delay recovery and even reduce long-term function. Impaired walking ability is at the head of the list. Gangrene and loss of limb are among the worst possibilities.
These are not meant to be scare tactics. The simple fact is that adults with diabetes are more likely than adults without diabetes to fracture a bone. And when they do, half of them will develop one or more serious problems.
Patients and their families who are aware of the potential complications will take the directions seriously and follow them very carefully. A lot of education and a little prevention can go a long way in obtaining a good result for patients with diabetes.Saad B. Chaudhary, MD, MBA, et al. Complications of Ankle Fracture in Patients with Diabetes. In Journal of the American Academy of Orthopaedic Surgeons. March 2008. Vol. 16. No. 3. Pp. 159-170.
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