Background: Ankle fractures are a common injury among diabetics. Fixation of this type of fracture by plate and screws is an efficient method for treating diabetic patients with ankle fracture. So, we aimed to evaluate how diabetic individuals with firm internal fixation fared with the treatment of recent ankle fractures.

Methods: 30 diabetic patients with ankle fractures participated in this randomized clinical trial, which was conducted at the orthopedic emergency room of Zagazig University hospitals. The outcome of internal fixation of acute ankle fractures was assessed.

Results: Age and operating time have a statistically significant relationship with postoperative complications (both were significantly higher among complicated patients). Postoperative problems and AOFAS had a statistically significant relationship (good and excellent scores were obtained by 73.9% and 21.7% of non-complicated patients, respectively, compared to 14.3% and 14.3% of complicated patients). Postoperative problems are not statistically significantly correlated with neuro-vascularity, side of lesion, mechanism of injury, gender, occupation, smoking, or time preceding surgery.

Conclusion: Patients with diabetes who are uncontrolled and have a high HBA1C level experience more complications than those who have their diabetes under control. The recommended course of action for people with controlled diabetes who have unstable ankle fractures is open reduction and internal fixation using standard procedures. Soft-tissue and osseous problems, such as delayed union and nonunion, are more common in patients with uncontrolled diabetes and high HBA1C levels.