Two cases of recurrent thromboangiitis obliterans treated with tibial transverse transport surgery twice

This article summarized and analyzed the clinical data of two patients with thromboangiitis obliterans who were admitted to the Department of Hand Surgery of the Second Hospital of Jilin University (hereinafter referred to as our hospital) and underwent tibial transverse transport (TTT) surgery, and reviewed the latest literature. In January 2019, a 31-year-old male patient was admitted with a persistent wound on the end of his left big toe and intermittent pain in his left lower limb. After admission to our hospital, he underwent TTT surgery. A follow-up examination one week after surgery showed that the foot wound was reduced in area and scabbed. At 6 weeks postoperatively, the foot wound was nearly healed. At 20 months postoperatively, intermittent pain in the left lower limb recurred, accompanied by signs of partial tissue necrosis and blackening at the end of the left big toe. The patient was readmitted to our hospital for TTT surgery. In September 2019, a 48-year-old male patient was admitted to our hospital with a non-healing wound accompanied by pain on the fourth toe of his left foot that was partially resected at another hospital. After admission, he underwent TTT surgery and debridement and suture of the wound. The wound healed after half a month, and the patient was discharged from the hospital. At 9 months postoperatively, the patient was admitted to our hospital again due to gangrene and pain in the fourth toe of his left foot, and underwent TTT surgery again and amputation of the remaining fourth toe. The pain and other symptoms that recurred in the two aforementioned patients after their first TTT surgery were alleviated after they underwent the TTT surgery again. This indicates that TTT surgery for thromboangiitis obliterans has a certain time-limited effect. For patients with recurrence, if they meet the indications for TTT surgery, this treatment can be repeated to improve symptoms.