The triad predicting outcome of intertrochanteric femur fracture in uncontrolled diabetes mellitus

Purpose

Diabetes is becoming more influential factors in fracture outcomes.Our main aim of the study is regarding the factors affecting radiological and functional outcome in uncontrolled diabetes patients with hip fractures.

Methods

The study at Ganga Hospital examined the impact of diabetes control on hip fracture outcomes among 150 patients, divided into three groups: non-diabetics(HbA1c <6%), controlled diabetics (HbA1c 6-8%), and uncontrolled diabetics (HbA1c >8%) conducted from January 2022 to December 2022, the retrospective study focused on patients aged over 60years with Intertrochanteric femur fractures.

Results

• Healing and Functional Outcomes:Uncontrolled diabetics showed the poorest healing rates, with lower RUSH scores over time, indicating slower fracture recovery compared to controlled diabetics and non-diabetics.Functional outcomes, measured by the Katz score, were also significantly worse in uncontrolled diabetics.
• Bone Quality and Vitamin D Levels:Uncontrolled diabetics had the lowest BMD(T score), with higher rates of osteopenia and osteoporosis.They also had the highest incidence of vitamin D deficiency.
• Complications and Mortality:Higher complication rates and longer hospital stays were noted in uncontrolled diabetics.The Charlson Comorbidity Index (CCI) was significantly higher in these patients, correlating with increased mortality rates.Statistic analysis was done using one-way ANOVA test and significance was determined with p values(<0.05) using median values of all 3 groups.

Conclusion

The Charlson Comorbidity Index, bone mineral density (BMD) T-score, and Vitamin D were significant predictors of outcomes.The study highlights the severe impact of uncontrolled diabetes on hip fracture management, emphasizing the need for effective diabetes control to improve fracture outcomes and reduce associated complications.