Medium- and long-term clinical efficacy of tibial transverse transport in the treatment of diabetic foot ulcers

Liu Siwen; Jia Zhongwei; Zhang Zihang; Guo Zhao; Zhang Xiangxiang; Luo Qian

doi:10.3760/cma.j.cn501225-20241028-00417

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > > Accepted Manuscript

Liu Siwen,Jia Zhongwei,Zhang Zihang,et al.Medium- and long-term clinical efficacy of tibial transverse transport in the treatment of diabetic foot ulcers[J].Chin J Burns Wounds,2026,42(3):1-9.DOI: 10.3760/cma.j.cn501225-20241028-00417.

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Medium- and long-term clinical efficacy of tibial transverse transport in the treatment of diabetic foot ulcers

doi: 10.3760/cma.j.cn501225-20241028-00417

1.
The Fifth Clinical Medical College, Shanxi Medical University, Taiyuan 030000, China
2.
Department of Orthopedics, Shanxi Provincial People's Hospital, Taiyuan 030000, China
3.
Department of General Practice, Xi'an Central Hospital, Xi'an 710000, China
4.
School of Public Health, Shanxi Medical University, Taiyuan 030000, China

Funds:

Basic Research Project of Shanxi Province 202103021224367

Scientific Research Project of Shanxi Provincial Health Commission 2023043

Key Medical Research Project of Shanxi Province 2023XM049

More Information

Corresponding author: Jia Zhongwei, Email: doctor_jiazw@sina.com
Received Date: 2024-10-28
Available Online: 2026-03-09

Abstract

Abstract

Objective To investigate the medium- and long-term clinical efficacy of tibial transverse transport (TTT) in the treatment of diabetic foot ulcers (DFU). Methods This study was a retrospective cohort study. From January 2015 to December 2022, 87 patients with diabetic foot ulcers who met the inclusion criteria were admitted to the Department of Orthopedics of Shanxi Provincial People's Hospital and were treated with TTT. Due to amputation, death, or loss to follow-up of patients, the number of cases was 85, 82, 77, 73, and 62 at 3 months, 6 month, 1 year, 2 years, and 3 years postoperatively. The ankle brachial index (ABI), Michigan Neuropathy Screening Instrument (MNSI) physical examination score, 10 g monofilament test results, visual analogue scale (VAS) score, toe oxygen saturation was recorded preoperatively and at 1 month, 3 months, 6 months, 1 year, 2 years, and 3 years postoperatively. The occurrence of complications, wound healing, and amputation were recorded during 3 years postoperatively. Results The levels of ABI were 0.70 (0.65, 0.76), 0.93 (0.83, 1.01), 0.96 (0.86, 1.06), 0.93 (0.88, 1.01), 0.91 (0.86, 0.97), and 0.90 (0.81, 0.97) at 1 month, 3 months, 6 months, 1 year, 2 years, and 3 years postoperatively, which were significantly higher than 0.55 (0.47, 0.62) preoperatively (P<0.05). At 1 month, 3 months, 6 months, 1 year, 2 years, and 3 years postoperatively, the 10 g monofilament test scores were significantly more than those preoperatively (P<0.05), the VAS scores and MNSI physical examination scores were significantly lower than those preoperatively (P<0.05), and the levels of toe oxygen saturation were significantly higher than those preoperatively (P<0.05). During 3 years postoperatively, 3 patients experienced fractures at the bone transport site, and 4 patients developed infections at the pin tract and incision, all of whom recovered with conservative treatment. The wounds healed in 80 patients, and limbs were salvaged in 80 patients. Conclusions Patients with DFU and treated with TTT can significantly improve lower limb blood supply and foot microcirculation, alleviate pain, and enhance nerve conduction function and foot sensation, with few complications and remarkable results in wound healing and limb salvage. Besides, the overall efficacy within 3 years postoperatively was good.
- Diabetic foot,
- Ulcer,
- Ankle brachial index,
- Tibial transverse transport,
- Medium- and long-term postoperative efficacy

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