Arthrodesis of the diabetic neuropathic ankle joint

Clin Orthop Relat Res. 1990 Apr;(253):209-11.


At the authors' institution from 1964 to 1984, ankle arthrodesis was performed in 13 patients with insulin-dependent diabetes mellitus who had a history of ankle sprain or fracture. Nine patients were diagnosed by clinical exam as having a peripheral neuropathy; nine patients had roentgenographic evidence of neuropathic arthropathy prior to surgery. Follow-up study with examination and roentgenograms averaged 42 months. Clinical and roentgenographic union was achieved in seven ankles at an average of 16 weeks. Two patients developed a nonunion, three had an amputation, and one died at two months postoperatively. Thirteen complications occurred in eight of the 13 patients (62%). Twenty reoperations, excluding pin removal, were performed in eight patients (62%). A satisfactory result was achieved in only 50% overall and in only 38% of patients with roentgenographic changes of neuropathic arthropathy. Neuropathic arthropathy contributes to the inordinate complication and failure rates. Ankle arthrodesis should be considered with caution in the diabetic patient.

MeSH terms

  • Adult
  • Aged
  • Ankle Joint / surgery*
  • Arthrodesis*
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetic Neuropathies / physiopathology
  • Diabetic Neuropathies / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prognosis
  • Reoperation