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Foot Ankle Clin ; 15(3): 411-37, 2010 Sep.
Article in English | MEDLINE | ID: mdl-20682414

ABSTRACT

Impaired soft tissue regeneration and delayed osseous healing are known complications associated with diabetes mellitus with regard to orthopedic surgery, making the management and treatment of diabetic patients undergoing foot and ankle surgery more complex and difficult. At the moment several options are available to address the known issues that complicate the clinical outcomes in these high-risk patients. Using a multifaceted approach, with close attention to intraoperative and perioperative considerations including modification of surgical technique to supplement fixation, local application of orthobiologics, tight glycemic control, administration of supplementary oxygen, and biophysical stimulation via low-intensity pulsed ultrasound and electrical bone stimulation, the impediments associated with diabetic healing can potentially be overcome, to yield improved clinical results for diabetic patients after acute or elective foot and ankle surgery.


Subject(s)
Bones of Lower Extremity/surgery , Diabetes Complications/surgery , Fracture Healing/physiology , Orthopedic Procedures/methods , Perioperative Care/methods , Wound Healing/physiology , Bone Morphogenetic Proteins/physiology , Bones of Lower Extremity/blood supply , Bones of Lower Extremity/innervation , Diabetes Complications/physiopathology , Diabetes Complications/therapy , Electric Stimulation Therapy/methods , Humans , Orthopedic Procedures/adverse effects , Perioperative Care/adverse effects , Platelet-Rich Plasma/physiology , Retrospective Studies
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