TY - JOUR
T1 - Factors Associated with Nonunion, Delayed Union, and Malunion in Foot and Ankle Surgery in Diabetic Patients
AU - Shibuya, Naohiro
AU - Humphers, Jon M.
AU - Fluhman, Benjamin L.
AU - Jupiter, Daniel C.
PY - 2013/3
Y1 - 2013/3
N2 - 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.
AB - 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.
KW - Bone
KW - Charcot foot
KW - Complication
KW - Diabetes mellitus
KW - Hyperglycemia
KW - Peripheral neuropathy
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=84873986258&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84873986258&partnerID=8YFLogxK
U2 - 10.1053/j.jfas.2012.11.012
DO - 10.1053/j.jfas.2012.11.012
M3 - Article
C2 - 23313498
AN - SCOPUS:84873986258
SN - 1067-2516
VL - 52
SP - 207
EP - 211
JO - Journal of Foot and Ankle Surgery
JF - Journal of Foot and Ankle Surgery
IS - 2
ER -