Diabetic ankle fracture complications: a meta-analysis.

ABSTRACT

INTRODUCTION: This meta-analysis aimed to review complication rates following the treatment of an ankle fracture in diabetic patients and to early detect the subgroup of patients at potential risk in order to minimise this complication rate. METHODS: A search of 3 databases was performed for studies published till March 2018. Twelve studies met the eligibility criteria for further statistical analysis. An odds ratio (OR) with a 95% confidence interval (95% CI) for each complication was calculated between the diabetic and non-diabetic groups. RESULTS: The overall complication risk after ankle fracture was twice as high in diabetes mellitus (DM) than non-diabetes mellitus (non-DM) patients (OR 1.9, 95%CI 1.7-2.03). This risk was considerably higher with surgery versus non-surgical treatment (OD 3.7, 95%CI 2.3-6.2). The risk of infection was 3 times higher in DM than in non-DM patients (OR 3.4, 95%CI 2.9-9.8). The complication rate was even higher in patients with advanced DM (OR 8.4, 95%CI 2.9-24.5). CONCLUSION: This meta-analysis provides evidence that diabetic patients are at a greater risk of complication after an ankle fracture.