Do patients with diabetes have an increased risk of impaired fracture healing? A systematic review and meta-analysis
| Autor: | Xiao Rong, Zongke Zhou, Zhi‐min Liang, Wei-Nan Zeng, Zichuan Ding |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Long bone Bone healing 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Internal medicine Medicine Humans Malunion Fracture Healing business.industry Incidence (epidemiology) General Medicine Odds ratio medicine.disease Confidence interval medicine.anatomical_structure Diabetes Mellitus Type 2 030220 oncology & carcinogenesis Meta-analysis Fractures Ununited 030211 gastroenterology & hepatology Surgery business Osteoporotic Fractures Leg Injuries |
| Zdroj: | ANZ journal of surgeryReferences. 90(7-8) |
| ISSN: | 1445-2197 |
| Popis: | Background The majority of the existing evidence showing an association between diabetes and impaired fracture healing comes from basic scientific research. This systematic review and meta-analysis aimed to summarize the current clinical literature that investigates fracture healing in patients with diabetes. Methods The outcome of interest was impaired fracture healing including non-union, delayed union and malunion. Studies that compared fracture healing outcomes between patients with and without diabetes were included in this study. Subgroup analyses regarding different fracture sites, types of fracture and classifications of diabetes were performed. Results A total of 14 studies involving 695 patients with diabetes and 4937 controls fulfilled the inclusion criteria. Diabetes was associated with an increased risk of impaired fracture healing (odds ratio (OR): 2.11, 95% confidence interval (CI) 1.33-3.37, P = 0.002). Subgroup analyses showed that diabetes was associated with a significantly higher incidence of impaired fracture healing in lower extremity fractures (OR 2.63, 95% CI 1.30-5.30, P = 0.007), short bone fractures (OR 2.64, 95% CI 1.35-5.20, P = 0.005), long bone fractures (OR 2.13, 95% CI 1.23-3.70, P = 0.007) and osteoporosis-unrelated fractures (OR 2.39, 95% CI 1.19-4.80, P = 0.01). Both insulin-dependent diabetes (OR 4.04, 95% CI 1.05-15.56, P = 0.04) and non-insulin-dependent diabetes (OR 5.83, 95% CI 1.73-19.58, P = 0.004) were associated with significantly higher risks of impaired fracture healing. Conclusions Patients with diabetes have an increased risk of impaired fracture healing when compared to patients without diabetes. Fracture healing in the lower extremities, short bones and osteoporosis-unrelated fractures is affected more severely by diabetes. |
| Databáze: | OpenAIRE |
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