Radiological and functional outcomes after surgical fixation of closed ankle fractures in diabetic patients

Background: Diabetes mellitus is associated with impaired fracture healing, increased infection risk, and higher complication rates following ankle fracture surgery. Achieving stable fixation and anatomical reduction is critical in this high-risk population to optimize functional recovery and radiological alignment. Objective: To evaluate the functional and radiological outcomes of operatively managed closed ankle fractures in diabetic patients and to assess postoperative complications. Methods: This ambispective observational study was conducted at a tertiary care center between November 2021 and September 2023. Thirty-five adult diabetic patients with closed ankle fractures treated with open reduction and internal fixation (ORIF) were included. Functional outcomes were assessed using the Visual Analog Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) score at 1, 3, and 6 months. Radiological parameters including medial clear space, tibiofibular clear space, talocrural angle, talar shift, and posterior subluxation were evaluated pre- and postoperatively. Statistical analysis was performed using paired tests with significance set at p < 0.05. Results: The mean age was 43.0±9.5 years. Significant improvement was observed in pain and function, with VAS scores decreasing significantly by 6 months (p