Triplanar osteotomy combined with proximal tibial transverse transport to accelerate healing of recalcitrant diabetic foot ulcers
Management of recalcitrant diabetic foot ulcers remains challenging. Tibial transverse transport (TTT) is an effective method for enhancing the healing of foot ulcers. This retrospective study reports a novel triplanar osteotomy in the tibia and assesses the clinical outcomes of TTT for diabetic foo...
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| Veröffentlicht in: | Journal of orthopaedic surgery and research 2022-12, Vol.17 (1), p.528-528 |
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| creator | Xu, Jia Li, Shanyu Sun, Yunchu Bao, Bingbo Zhu, Tianhao Kang, Qinglin Zheng, Xianyou Wen, Gen |
| description | Management of recalcitrant diabetic foot ulcers remains challenging. Tibial transverse transport (TTT) is an effective method for enhancing the healing of foot ulcers. This retrospective study reports a novel triplanar osteotomy in the tibia and assesses the clinical outcomes of TTT for diabetic foot ulcers.
Fifty-nine patients with recalcitrant diabetic foot ulcers were divided into the TTT (32 patients) and control (27 patients) groups. In the TTT group, the patients underwent triplanar osteotomy of the proximal tibia, followed by 2 weeks of medial distraction and 2 weeks of lateral distraction. In the control group, the patients received conventional management, including debridement, revascularization, and reconstruction. Ulcer healing and healing time, amputation, recurrence, and complications were assessed at an 18-month follow-up visit. Computed tomography angiography (CTA) was used to evaluate vessel changes in the lower limbs of patients in the TTT group.
The TTT group was superior to the control group in the healing rate (90.6% [29/32] vs. 66.7% [18/27]) and the healing time (4.6 ± 1.7 months vs. 7.4 ± 2.5 months), respectively. The proportions of amputation and recurrence in the TTT group were lower than that in the control group, without statistical difference. After triplanar osteotomy and transverse distraction, CTA demonstrated an increase in small vessels in the wound and ipsilateral limb. All patients achieved satisfactory union of the osteotomized bone fragment after removal of the external fixator.
Triplanar osteotomy combined with proximal tibial transverse distraction accelerates wound healing and limb salvage caused by severe and recalcitrant diabetic foot ulcers. Triplanar osteotomy not only increases the bone contact area, which is beneficial for rapid bone reconstruction, but also preserves the vascularization of the bone fragment and substantially facilitates capillary angiogenesis during distraction. These results suggest that triplanar osteotomy followed by tibial transverse distraction is an effective method for treating diabetic foot ulcers. |
| doi_str_mv | 10.1186/s13018-022-03410-z |
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Fifty-nine patients with recalcitrant diabetic foot ulcers were divided into the TTT (32 patients) and control (27 patients) groups. In the TTT group, the patients underwent triplanar osteotomy of the proximal tibia, followed by 2 weeks of medial distraction and 2 weeks of lateral distraction. In the control group, the patients received conventional management, including debridement, revascularization, and reconstruction. Ulcer healing and healing time, amputation, recurrence, and complications were assessed at an 18-month follow-up visit. Computed tomography angiography (CTA) was used to evaluate vessel changes in the lower limbs of patients in the TTT group.
The TTT group was superior to the control group in the healing rate (90.6% [29/32] vs. 66.7% [18/27]) and the healing time (4.6 ± 1.7 months vs. 7.4 ± 2.5 months), respectively. The proportions of amputation and recurrence in the TTT group were lower than that in the control group, without statistical difference. After triplanar osteotomy and transverse distraction, CTA demonstrated an increase in small vessels in the wound and ipsilateral limb. All patients achieved satisfactory union of the osteotomized bone fragment after removal of the external fixator.
Triplanar osteotomy combined with proximal tibial transverse distraction accelerates wound healing and limb salvage caused by severe and recalcitrant diabetic foot ulcers. Triplanar osteotomy not only increases the bone contact area, which is beneficial for rapid bone reconstruction, but also preserves the vascularization of the bone fragment and substantially facilitates capillary angiogenesis during distraction. These results suggest that triplanar osteotomy followed by tibial transverse distraction is an effective method for treating diabetic foot ulcers.</description><identifier>ISSN: 1749-799X</identifier><identifier>EISSN: 1749-799X</identifier><identifier>DOI: 10.1186/s13018-022-03410-z</identifier><identifier>PMID: 36482382</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Amputation ; Angiogenesis ; Angiography ; Ankle ; Care and treatment ; Computed tomography ; Debridement ; Diabetes ; Diabetes mellitus ; Diabetic foot ; Feet ; Foot diseases ; Hospitals ; Infections ; Ischemia ; Leg ulcers ; Metabolism ; Orthopedics ; Osteotomy ; Patients ; Skin & tissue grafts ; Tibia ; Ulcers ; Vascularization ; Wound healing ; Wounds and injuries</subject><ispartof>Journal of orthopaedic surgery and research, 2022-12, Vol.17 (1), p.528-528</ispartof><rights>2022. The Author(s).</rights><rights>COPYRIGHT 2022 BioMed Central Ltd.</rights><rights>2022. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733084/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733084/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36482382$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xu, Jia</creatorcontrib><creatorcontrib>Li, Shanyu</creatorcontrib><creatorcontrib>Sun, Yunchu</creatorcontrib><creatorcontrib>Bao, Bingbo</creatorcontrib><creatorcontrib>Zhu, Tianhao</creatorcontrib><creatorcontrib>Kang, Qinglin</creatorcontrib><creatorcontrib>Zheng, Xianyou</creatorcontrib><creatorcontrib>Wen, Gen</creatorcontrib><title>Triplanar osteotomy combined with proximal tibial transverse transport to accelerate healing of recalcitrant diabetic foot ulcers</title><title>Journal of orthopaedic surgery and research</title><addtitle>J Orthop Surg Res</addtitle><description>Management of recalcitrant diabetic foot ulcers remains challenging. Tibial transverse transport (TTT) is an effective method for enhancing the healing of foot ulcers. This retrospective study reports a novel triplanar osteotomy in the tibia and assesses the clinical outcomes of TTT for diabetic foot ulcers.
Fifty-nine patients with recalcitrant diabetic foot ulcers were divided into the TTT (32 patients) and control (27 patients) groups. In the TTT group, the patients underwent triplanar osteotomy of the proximal tibia, followed by 2 weeks of medial distraction and 2 weeks of lateral distraction. In the control group, the patients received conventional management, including debridement, revascularization, and reconstruction. Ulcer healing and healing time, amputation, recurrence, and complications were assessed at an 18-month follow-up visit. Computed tomography angiography (CTA) was used to evaluate vessel changes in the lower limbs of patients in the TTT group.
The TTT group was superior to the control group in the healing rate (90.6% [29/32] vs. 66.7% [18/27]) and the healing time (4.6 ± 1.7 months vs. 7.4 ± 2.5 months), respectively. The proportions of amputation and recurrence in the TTT group were lower than that in the control group, without statistical difference. After triplanar osteotomy and transverse distraction, CTA demonstrated an increase in small vessels in the wound and ipsilateral limb. All patients achieved satisfactory union of the osteotomized bone fragment after removal of the external fixator.
Triplanar osteotomy combined with proximal tibial transverse distraction accelerates wound healing and limb salvage caused by severe and recalcitrant diabetic foot ulcers. Triplanar osteotomy not only increases the bone contact area, which is beneficial for rapid bone reconstruction, but also preserves the vascularization of the bone fragment and substantially facilitates capillary angiogenesis during distraction. These results suggest that triplanar osteotomy followed by tibial transverse distraction is an effective method for treating diabetic foot ulcers.</description><subject>Amputation</subject><subject>Angiogenesis</subject><subject>Angiography</subject><subject>Ankle</subject><subject>Care and treatment</subject><subject>Computed tomography</subject><subject>Debridement</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetic foot</subject><subject>Feet</subject><subject>Foot diseases</subject><subject>Hospitals</subject><subject>Infections</subject><subject>Ischemia</subject><subject>Leg ulcers</subject><subject>Metabolism</subject><subject>Orthopedics</subject><subject>Osteotomy</subject><subject>Patients</subject><subject>Skin & tissue grafts</subject><subject>Tibia</subject><subject>Ulcers</subject><subject>Vascularization</subject><subject>Wound healing</subject><subject>Wounds and injuries</subject><issn>1749-799X</issn><issn>1749-799X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptkU1rFTEUhoMotlb_gAsJuHEzNV8zk2yEUvyCgpsK7kImc-belEwyJpnWuvOfm6FVbkVCOIfkOe_Je4LQS0pOKZXd20w5obIhjDWEC0qan4_QMe2Fanqlvj0-yI_Qs5yvCGlJK8VTdMQ7IRmX7Bj9ukxu8SaYhGMuEEucb7GN8-ACjPjGlT1eUvzhZuNxcYPbQjIhX0PKcJcuMRVcIjbWgodkCuA9GO_CDscJJ7DGW7eRBY_ODFCcxVOMBa_eVpXn6MlkfIYX9_EEff3w_vL8U3Px5ePn87OLZsc7WhpuOOnAUqWo6O0olAXKiDVcydHCAACtMqMwdSaEWdYzMlrDBkEmRXnfcn6C3t3pLuswQ60J9U1eL6l6S7c6Gqcf3gS317t4rVXPOZGiCry5F0jx-wq56NnlarlOD-KaNdu6EK6IrOjrf9CruKZQ7W1U27WSqQNqZzxoF6ZY-9pNVJ_1TAlRN6vU6X-oukaYnY0BJlfPHxS8OjT61-GfT-e_AT-3shk</recordid><startdate>20221208</startdate><enddate>20221208</enddate><creator>Xu, Jia</creator><creator>Li, Shanyu</creator><creator>Sun, Yunchu</creator><creator>Bao, Bingbo</creator><creator>Zhu, Tianhao</creator><creator>Kang, Qinglin</creator><creator>Zheng, Xianyou</creator><creator>Wen, Gen</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>NPM</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20221208</creationdate><title>Triplanar osteotomy combined with proximal tibial transverse transport to accelerate healing of recalcitrant diabetic foot ulcers</title><author>Xu, Jia ; 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Tibial transverse transport (TTT) is an effective method for enhancing the healing of foot ulcers. This retrospective study reports a novel triplanar osteotomy in the tibia and assesses the clinical outcomes of TTT for diabetic foot ulcers.
Fifty-nine patients with recalcitrant diabetic foot ulcers were divided into the TTT (32 patients) and control (27 patients) groups. In the TTT group, the patients underwent triplanar osteotomy of the proximal tibia, followed by 2 weeks of medial distraction and 2 weeks of lateral distraction. In the control group, the patients received conventional management, including debridement, revascularization, and reconstruction. Ulcer healing and healing time, amputation, recurrence, and complications were assessed at an 18-month follow-up visit. Computed tomography angiography (CTA) was used to evaluate vessel changes in the lower limbs of patients in the TTT group.
The TTT group was superior to the control group in the healing rate (90.6% [29/32] vs. 66.7% [18/27]) and the healing time (4.6 ± 1.7 months vs. 7.4 ± 2.5 months), respectively. The proportions of amputation and recurrence in the TTT group were lower than that in the control group, without statistical difference. After triplanar osteotomy and transverse distraction, CTA demonstrated an increase in small vessels in the wound and ipsilateral limb. All patients achieved satisfactory union of the osteotomized bone fragment after removal of the external fixator.
Triplanar osteotomy combined with proximal tibial transverse distraction accelerates wound healing and limb salvage caused by severe and recalcitrant diabetic foot ulcers. Triplanar osteotomy not only increases the bone contact area, which is beneficial for rapid bone reconstruction, but also preserves the vascularization of the bone fragment and substantially facilitates capillary angiogenesis during distraction. These results suggest that triplanar osteotomy followed by tibial transverse distraction is an effective method for treating diabetic foot ulcers.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>36482382</pmid><doi>10.1186/s13018-022-03410-z</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Amputation Angiogenesis Angiography Ankle Care and treatment Computed tomography Debridement Diabetes Diabetes mellitus Diabetic foot Feet Foot diseases Hospitals Infections Ischemia Leg ulcers Metabolism Orthopedics Osteotomy Patients Skin & tissue grafts Tibia Ulcers Vascularization Wound healing Wounds and injuries |
| title | Triplanar osteotomy combined with proximal tibial transverse transport to accelerate healing of recalcitrant diabetic foot ulcers |
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