Ankle Surgery Recovery for Diabetics

I brought my mother home from the hospital last night after ankle surgery. She has diabetes, and the nurses gave us a long list of instructions, emphasizing that we need to follow them exactly. My sister and I have been caring for her all our lives, so why is everyone making such a big deal about this?

It’s great that your mother is being cared for at home, but the hospital staff may not always know the full extent of a patient’s support system. For individuals with diabetes, there are additional challenges that require careful attention during recovery.

First, healing can be significantly slower in people with diabetes. Even with excellent care, there’s a risk that the fracture may not heal properly, leading to complications such as nonunion (where the bones don’t fuse together) or malunion (where they heal in the wrong position). This can affect her ability to walk, balance, and coordinate movements.

One of the most serious concerns is the heightened risk of complications, including amputation. The rate of complications for patients with diabetes and fractures is nearly three times higher than for those without diabetes. Almost half of diabetic patients with fractures encounter some form of problem during recovery.

Several factors contribute to this delayed healing process. Chronic diabetes often leads to damage in the small blood vessels, which are essential for delivering oxygen and nutrients to the injured tissues and bones. Without adequate blood supply, healing can be compromised.

In addition, long-term elevated blood sugar levels can cause nerve damage. This nerve damage, particularly in the peripheral nerves, can result in a loss of sensation in the feet, leaving the area vulnerable to unnoticed trauma, pressure sores, and even gangrene.

Following the postoperative instructions to the letter is crucial for achieving a successful outcome. Close communication with her primary care physician and any other healthcare providers involved in her recovery is essential over the coming months.

Lastly, one more “Don’t” to keep in mind: Don’t hesitate to reach out to her nurse or doctor if you notice anything unusual or if you have concerns. Early detection of potential problems can prevent more severe complications later on.

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.