Clinical effects of tibial periosteal distraction combined with antibiotic bone cement in treating diabetic foot ulcer

Chen Yan; Feng Lei; Huang Ting; Zheng Yangyang; Ma Jie; Wu Jian

doi:10.3760/cma.j.cn501225-20241007-00375

Volume 41 Issue 7

Jul. 2025

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Chen Yan, Feng Lei, Huang Ting, et al. Clinical effects of tibial periosteal distraction combined with antibiotic bone cement in treating diabetic foot ulcer[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2025, 41(7): 655-664. Doi: 10.3760/cma.j.cn501225-20241007-00375

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Clinical effects of tibial periosteal distraction combined with antibiotic bone cement in treating diabetic foot ulcer

doi: 10.3760/cma.j.cn501225-20241007-00375

1.
Department of Burns, Gansu Provincial People's Hospital, Lanzhou 730000, China
2.
The First Clinical Medical College, Gansu University of Traditional Chinese Medicine, Lanzhou 730099, China

Funds:

Gansu Provincial Science and Technology Plan Project 23YFFA0050

Gansu Provincial Science and Technology Plan Project 21JR7RA674

Gansu Provincial Science and Technology Plan Project 23JRRA1285

Lanzhou Science and Technology Plan Project 2023-ZD-29

Lanzhou Science and Technology Plan Project 2024-9-21

Gansu Provincial People's Hospital Internal Medicine Research Fund Project 23GSSYB-13

More Information

Corresponding author: Wu Jian, Email: 2005yjswj@163.com
Received Date: 2024-10-07

Abstract

Abstract

Objective To explore the clinical effects of tibial periosteal distraction combined with antibiotic bone cement in treating diabetic foot ulcer. Methods The study was a retrospective observational study. From March 2021 to March 2024, 52 patients with diabetic foot ulcers who met the inclusion criteria were admitted to Gansu Provincial People's Hospital, including 25 males and 27 females, aged 34-77 years. According to the treatment methods used by the patients, they were divided into control group (22 cases) treated with antibiotic bone cement alone and combined group (30 cases) treated with tibial periosteal distraction combined with antibiotic bone cement. Toe amputation rate, limb amputation rate, length of hospitalization, and ulcer healing time-consuming of patients were recorded. Before the first treatment and 3 weeks after the last treatment, the ankle skin temperature and ankle-brachial index of the affected foot were measured routinely, the pain of the affected foot was evaluated by using visual analog scale (VAS), and the peripheral nerve function of the affected foot was evaluated by 10 g nylon thread examination (denoted as 10 g nylon thread test value). Three weeks after the last treatment, the clinical efficacy of patients was evaluated and the overall rate of clinical efficacy was calculated. Results There were no statistically significant differences in the comparison of toe amputation rate and limb amputation rate of patients in the 2 groups (P > 0.05). The length of hospitalization and ulcer healing time-consuming of patients in combined group were (23±5) and (41±6) d, respectively, which were significantly shorter than (27±5) and (46±6) d in control group (with t values of 3.08 and 3.18, respectively, both P values < 0.05). The ankle skin temperature of the affected foot of patients in combined group was (34.1±1.5) ℃, and the ankle-brachial index was 0.72±0.08 three weeks after the last treatment, which were significantly higher than (32.1±1.6) ℃ and 0.58±0.09 before the first treatment within the group (with t values of 5.10 and 6.37, respectively, P < 0.05) and (31.8±1.1) ℃ and 0.59±0.09 three weeks after the last treatment in control group (with t values of 6.88 and 5.49, respectively, P < 0.05). The pain VAS score of the affected foot of patients in combined group 3 weeks after the last treatment was significantly lower than that before the first treatment within the group and 3 weeks after the last treatment in control group (with t values of 8.16 and 6.83, respectively, both P values < 0.05), and the 10 g nylon thread test value was significantly higher than that before the first treatment within the group and 3 weeks after the last treatment in control group (with t values of 6.15 and 4.23, respectively, both P values < 0.05). Three weeks after the last treatment, the overall rate of clinical efficacy of patients in combined group was 96.7% (29/30), which was significantly higher than 63.6% (14/22) in control group, χ²=7.51, P < 0.05. Conclusions Tibial periosteal distraction combined with antibiotic bone cement has good clinical effects in the treatment of diabetic foot ulcers. It can shorten the length of patients' hospitalization, promote the healing of the ulcers, reduce the pain in the affected foot, and improve the blood supply and peripheral nerve function in the affected foot.
- Diabetic foot,
- Pain,
- Ankle brachial index,
- Peripheral nerves,
- Tibial periosteal distraction,
- Blood circulation,
- Antibiotic bone cement,
- Wound repair

(1) The use of tibial periosteal distraction on the basis of antibiotic bone cement to treat diabetic foot ulcers could effectively improve the blood supply to the lower limbs, promote ulcer healing, alleviate patients' pain, and shorten the length of hospitalization.
(2) This procedure caused little injury, was simple to perform, and could be used as a new option for the treatment of diabetic foot ulcers.

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References(41)

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