The Consolidation of Fractures of the Distal Metaepiphysis of the Radial Bone in Patients with Diabetes Mellitus: Problems and Solution Approaches

The fractures of the distal segment of the radial bone in diabetes mellitus patients is a problem which requires special attention, for the processes of healing in such patients are slower and are often accompanied by a number of complications. This article reviews the basic mechanisms affecting the consolidation of fractures in diabetes patients, including the metabolic disorders, the hyperglycemia, the micro- and macroangiopathy, the polyneuropathy and other systemic abnormalities. An analysis was carried out of the specific features of the anatomy of the distal metaepiphysis of the radial bone, which make it vulnerable to fractures that are difficult to heal. The research provides a detailed analysis of the factors inhibiting the regeneration of the bone tissue, such as the accumulation of glycation end-products, the increased activity of the osteoclasts, the decreased immune protection and the high risk of infectious complications. Also, the methods were highlighted that are used for prevention and treatment, including the control of glucose levels, the correction of vitamin D deficit, the repositioning of the fractured bone fragments and the reliable immobilization. The research emphasizes the necessity of combined approach to the treatment of fractures in diabetes patients, with taking into consideration both the orthopedic and the endocrinological aspects.