Aim: This study describes a treatment algorithm for addressing failed ankle open reduction and internal fixation (ORIF) in diabetic patients using two successful patient cases.
Background: The complication rate following ankle fracture ORIF in diabetic patients is significantly higher compared to that in nondiabetic patients and salvage techniques are limited. Complications include soft tissue problems and increased infection rate, impaired bone healing and the possibility of a lost reduction, and Charcot arthropathy.
Case description: We analyze two cases of failed ORIF following traumatic ankle fracture in diabetic patients. Both patients underwent salvage procedures utilizing skinny wire external fixators with tibiotalocalcaneal stabilization via one or two Steinmann pins and were initiated on an 8-week course of IV antibiotics.
Conclusion: Use of external fixation with tibiotalocalcaneal Steinmann pin fixation and IV antibiotics is an effective treatment after failed ankle ORIF in diabetic patients.
Clinical significance: An algorithm to salvage failed ankle ORIF can help avoid the worst outcomes in diabetic patients.
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