Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-12-01 Cooperative journals: 《中国全科医学》
Abstract：
Objective Explore improvements tibial transverse bone transport technology(TTT) :combined transport of bone and periosteum in the treatment of Wagner grade 3 and 4 diabetic foot patients. Methods The clinical data of 117 diabetic foot patients treated with TTT technology from January 2018 to May 2021 were retrospectively analyzed, and the postoperative foot-preservation rate, functional limb salvage rate, major amputation rate, ulcer healing time, complication rate, improvement of foot skin temperature, resting pain and comparison of preoperative and postoperative CTA were analyzed by its own before-and-after control study methods. Result All patients were followed up for 5.5 to 24 months, with an average of (14.21 �4.06) months. The postoperative foot retention rate (unexcitated limb or below ankle amputation) was 95.73% (112/117), the functional limb preservation rate (unexcitated or small amputation in the middle of the midfoot to the far part) was 83.76% (98/117), the major amputation rate (amputation above the ankle) was 4.27% (5/117), and the postoperative ulcers healed well except for amputated patients, with a healing time of 6 to 14.5 weeks, and the mean time was (9.07�2.02) weeks; The postoperative foot temperature of the patients was significantly improved compared with the preoperative period (P<0.01); the foot pain of the patients with resting pain was significantly relieved compared with the previous period (P<0.01); the CTA showed that the postoperative vascular condition improved in 70.34% (94/117) of the patients, the number of microvascular vessels increased, and the blood vessel network of the foot was reconstructed; The complication rate during bone handling was 11.97% (14/117), among which the incidence of osteotomy area skin edge necrosis, lower extremity venous thrombosis, and nail infection was 5.98% (7/117), 4.27% (5/117), and 1.71% (2/117), respectively. Conclusion Improved TTT technology (joint transport of bone and periosteum) It can promote wound healing by stimulating the reconstruction of lower limb microcirculation, effectively relieve the symptoms of resting pain in diabetic foot patients in the short term, improve foot temperature, and greatly reduce the complication rate compared with the traditional tibial transverse bone transport technology, which provides an effective means for the treatment of diabetic foot.
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