Effectiveness of transverse tibial bone transport in treatment of diabetic foot ulcer_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Hongye ,  YOU Jiaxing , LIU Chao , MA Yan

Department of Orthopedics, Xiasha Campus, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou Zhejiang, 310018, P.R.China;

Corresponding?author：

YOU Jiaxing, Email: jiaxingyou@126.com

Keywords：

Transverse tibial bone transport; diabetic foot; ulcer

DOI：

10.7507/1002-1892.201807143

Video：

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Objective To evaluate the effectiveness of transverse tibial bone transport in treatment of diabetic foot ulcer. Methods Between June 2014 and December 2017, 17 patients with diabetic foot ulcer were treated. There were 11 males and 6 females, with a median age of 57 years (range, 46-72 years). The duration of diabetes was 2.4-32.0 years (mean, 16.0 years). According to the Wagner grading criteria, 7 cases were rated as grade 2, 8 cases as grade 3, and 2 cases as grade 4. The CT angiography (CTA) showed the arterial occlusion or stenosis of varying degrees below knee joint. All cases were treated with transverse tibial bone transport. Bone transport started at 3 to 5 days after placing external fixator and lasted 14 days (1 mm per day), and then reverse transport started. The total transport time was 28-30 days. Results All 17 patients were followed up 5-12 months (mean, 8.5 months). During transportation, 4 cases had screw orifice infection, and 3 cases had liquefaction and seepage. And other 15 cases ulcers healed and the healing time was 35-72 days (mean, 48 days). There were significant differences in visual analogue scale (VAS) scores, skin temperature, ankle brachial index (ABI) between before and after ulcer healed (P<0.05). The CTA showed that the collateral circulation was established. The foot ulcer of 2 cases (Wagener grade 3 in 1 case and grade 4 in 1 case) still progressed after treatment, and amputation was performed. Conclusion Transverse tibial bone transports has good effectiveness for diabetic foot ulcer.

Citation： LI Hongye, YOU Jiaxing, LIU Chao, MA Yan. Effectiveness of transverse tibial bone transport in treatment of diabetic foot ulcer. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(1): 23-27. doi: 10.7507/1002-1892.201807143 Copy

1.	Jiang YJ, Wang XM, Xia L, et al. A cohort study of diabetic patients and diabetic foot ulceration patients in China. Wound Repair and Regeneration, 2015, 23(2): 222-230.
2.	高磊, 王碩, 王雷, 等. 皮膚牽張閉合器在糖尿病足創面修復中的應用. 中國修復重建外科雜志, 2018, 32(5): 591-595.
3.	李來春, 王愛紅, 胡呈煒, 等. 糖尿病足患者住院費用調查及影響因素的研究. 中國糖尿病雜志, 2017, 25(4): 339-343.
4.	余霄, 俞光榮. 糖尿病足截肢技術進展. 中國修復重建外科雜志, 2011, 25(6): 750-754.
5.	徐波, 楊彩哲, 吳石白, 等. 糖尿病足患者截肢相關危險因素分析. 中華內科雜志, 2017, 56(1): 24-28.
6.	王江寧, 高磊. 糖尿病足慢性創面治療的新進展. 中國修復重建外科雜志, 2018, 32(7): 832-837.
7.	Coxon JP, Gallen IW. Laterality of lower limb amputation in diabetic patients: retrospective audit. BMJ, 1999, 318(7180): 367-369.
8.	Ilizarov GA. The tension-stress effect on the genesis and growth of tissues: Part Ⅱ. The influence of the rate and frequency of distraction. Clin Orthop Relat Res, 1989, 239: 263-285.
9.	Makarov M, Birch J, Samchukov M. The role of variable muscle adaptation to limb lengthening in the development of joint contractures: an experimental study in the goat. Journal of Pediatric Orthopedics, 2009, 29(2): 175-181.
10.	鎮普祥, 陳炎, 高偉, 等. 應用 Ilizarov 技術脛骨橫向骨搬移術治療合并全身性炎癥反應綜合征的重度糖尿病足. 中國修復重建外科雜志, 2018, 32(10): 1261-1266.
11.	王斌, 楊漪舸. 股-股動脈旁路移植聯合脛骨橫向骨搬移術治療動脈硬化閉塞癥一例. 中國修復重建外科雜志, 2015, 29(9): 1188.
12.	曲龍, 王愛林, 湯福剛. 脛骨橫向搬移血管再生術治療血栓閉塞性脈管炎. 中華醫學雜志, 2001, 81(10): 622-624.
13.	徐顯章, 王愛林, 靖冬梅. 脛骨遷移血管再生治療血栓閉塞性脈管炎35例分析. 中國實用外科雜志, 2011, 31(6): 523-524.
14.	冼呈, 趙勁民, 蘇偉, 等. 脛骨橫向骨搬移微循環再生技術治療糖尿病足的臨床療效觀察. 廣西醫科大學學報, 2015, 32(4): 605-607.
15.	花奇凱, 王林, 冼呈, 等. Ilizarov脛骨橫向骨搬移微循環重建術治療下肢慢性缺血性疾病的臨床療效. 中國矯形外科雜志, 2015, 23(21): 2007-2011.
16.	花奇凱, 秦泗河, 趙良軍, 等. Ilizarov技術脛骨橫向骨搬移術治療糖尿病足. 中國矯形外科雜志, 2017, 25(4): 303-307.
17.	周強. CTA評價脛骨橫向骨搬移術治療老年糖尿病足的臨床療效. 影像研究與醫學應用, 2018, 2(3): 154-156.
18.	冼呈, 趙勁民, 蘇偉, 等. 外固定架骨搬移系統修復糖尿病足: 功能與影像學評價. 中國組織工程研究, 2015, 19(46): 7539-7544.

1. Jiang YJ, Wang XM, Xia L, et al. A cohort study of diabetic patients and diabetic foot ulceration patients in China. Wound Repair and Regeneration, 2015, 23(2): 222-230.
2. 高磊, 王碩, 王雷, 等. 皮膚牽張閉合器在糖尿病足創面修復中的應用. 中國修復重建外科雜志, 2018, 32(5): 591-595.
3. 李來春, 王愛紅, 胡呈煒, 等. 糖尿病足患者住院費用調查及影響因素的研究. 中國糖尿病雜志, 2017, 25(4): 339-343.
4. 余霄, 俞光榮. 糖尿病足截肢技術進展. 中國修復重建外科雜志, 2011, 25(6): 750-754.
5. 徐波, 楊彩哲, 吳石白, 等. 糖尿病足患者截肢相關危險因素分析. 中華內科雜志, 2017, 56(1): 24-28.
6. 王江寧, 高磊. 糖尿病足慢性創面治療的新進展. 中國修復重建外科雜志, 2018, 32(7): 832-837.
7. Coxon JP, Gallen IW. Laterality of lower limb amputation in diabetic patients: retrospective audit. BMJ, 1999, 318(7180): 367-369.
8. Ilizarov GA. The tension-stress effect on the genesis and growth of tissues: Part Ⅱ. The influence of the rate and frequency of distraction. Clin Orthop Relat Res, 1989, 239: 263-285.
9. Makarov M, Birch J, Samchukov M. The role of variable muscle adaptation to limb lengthening in the development of joint contractures: an experimental study in the goat. Journal of Pediatric Orthopedics, 2009, 29(2): 175-181.
10. 鎮普祥, 陳炎, 高偉, 等. 應用 Ilizarov 技術脛骨橫向骨搬移術治療合并全身性炎癥反應綜合征的重度糖尿病足. 中國修復重建外科雜志, 2018, 32(10): 1261-1266.
11. 王斌, 楊漪舸. 股-股動脈旁路移植聯合脛骨橫向骨搬移術治療動脈硬化閉塞癥一例. 中國修復重建外科雜志, 2015, 29(9): 1188.
12. 曲龍, 王愛林, 湯福剛. 脛骨橫向搬移血管再生術治療血栓閉塞性脈管炎. 中華醫學雜志, 2001, 81(10): 622-624.
13. 徐顯章, 王愛林, 靖冬梅. 脛骨遷移血管再生治療血栓閉塞性脈管炎35例分析. 中國實用外科雜志, 2011, 31(6): 523-524.
14. 冼呈, 趙勁民, 蘇偉, 等. 脛骨橫向骨搬移微循環再生技術治療糖尿病足的臨床療效觀察. 廣西醫科大學學報, 2015, 32(4): 605-607.
15. 花奇凱, 王林, 冼呈, 等. Ilizarov脛骨橫向骨搬移微循環重建術治療下肢慢性缺血性疾病的臨床療效. 中國矯形外科雜志, 2015, 23(21): 2007-2011.
16. 花奇凱, 秦泗河, 趙良軍, 等. Ilizarov技術脛骨橫向骨搬移術治療糖尿病足. 中國矯形外科雜志, 2017, 25(4): 303-307.
17. 周強. CTA評價脛骨橫向骨搬移術治療老年糖尿病足的臨床療效. 影像研究與醫學應用, 2018, 2(3): 154-156.
18. 冼呈, 趙勁民, 蘇偉, 等. 外固定架骨搬移系統修復糖尿病足: 功能與影像學評價. 中國組織工程研究, 2015, 19(46): 7539-7544.

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