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Transverse Tibial Bone Transport Enhances Distraction Osteogenesis and Vascularization in the Treatment of Diabetic Foot

OBJECTIVE: To investigate the effect of transverse tibial bone transport on the treatment of Wagner Stage 4 diabetic foot. METHODS: From January 2017 to October 2019, a total of 19 patients with Wagner Stage 4 diabetic foot ulcers were recruited. All patients were treated with transverse tibial bone...

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Autores principales: Ou, Shuanji, Xu, Changpeng, Yang, Yang, Chen, Ya, Li, Wenjun, Lu, Hanyu, Li, Guitao, Sun, Hongtao, Qi, Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9483085/
https://www.ncbi.nlm.nih.gov/pubmed/35946439
http://dx.doi.org/10.1111/os.13416
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author Ou, Shuanji
Xu, Changpeng
Yang, Yang
Chen, Ya
Li, Wenjun
Lu, Hanyu
Li, Guitao
Sun, Hongtao
Qi, Yong
author_facet Ou, Shuanji
Xu, Changpeng
Yang, Yang
Chen, Ya
Li, Wenjun
Lu, Hanyu
Li, Guitao
Sun, Hongtao
Qi, Yong
author_sort Ou, Shuanji
collection PubMed
description OBJECTIVE: To investigate the effect of transverse tibial bone transport on the treatment of Wagner Stage 4 diabetic foot. METHODS: From January 2017 to October 2019, a total of 19 patients with Wagner Stage 4 diabetic foot ulcers were recruited. All patients were treated with transverse tibial bone transport. A detailed follow‐up was carried out at 1 week, 1 month, 3 months, 6 months, and 1 year after surgery. The wound healing rate and the limb salvage rate at 1 year after the surgery were evaluated. Preoperative and 3‐month postoperative digital subtraction angiography (DSA) were obtained. The level of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), epidermal growth factor (EGF) and platelet‐derived growth factor (PDGF) before surgery and on 1st, 4th, 11th, 18th, 28(th), and 35th days after surgery were measured. Operation time, intraoperative blood loss, postoperative complications, visual analog scale (VAS) pain score, skin temperature, Semmes‐weinstein monofilament (SWM), and ankle brachial index (ABI) were also assessed. RESULTS: The wound healing rate and the limb salvage rate were both 94.74% in the patients at 1 year after the surgery. DSA showed the thickening of the calf and foot arteries, clear visualization, and a rich vascular network. The levels of VEGF, bFGF, and PDGF on the 11th, 18th, 28(th), and 35th days after surgery were significantly higher than those before surgery (p < 0.05). The EGF level on the 18th, 28th, and 35th days after surgery was significantly higher than that before surgery (p < 0.05). Superficial wound complications occurred in one patient during the hospitalization. There was no movement area infection, skin flap necrosis, tibial fracture, loosening of the external fixator, or rupture in study. CONCLUSION: Transverse tibial bone transport can improve the blood circulation of the affected limbs, promote the healing of diabetic foot wounds, and reduce the amputation rate of the affected limbs. Transverse tibial bone transport can promote the healing of Wagner Stage 4 diabetic foot.
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spelling pubmed-94830852022-09-29 Transverse Tibial Bone Transport Enhances Distraction Osteogenesis and Vascularization in the Treatment of Diabetic Foot Ou, Shuanji Xu, Changpeng Yang, Yang Chen, Ya Li, Wenjun Lu, Hanyu Li, Guitao Sun, Hongtao Qi, Yong Orthop Surg Clinical Articles OBJECTIVE: To investigate the effect of transverse tibial bone transport on the treatment of Wagner Stage 4 diabetic foot. METHODS: From January 2017 to October 2019, a total of 19 patients with Wagner Stage 4 diabetic foot ulcers were recruited. All patients were treated with transverse tibial bone transport. A detailed follow‐up was carried out at 1 week, 1 month, 3 months, 6 months, and 1 year after surgery. The wound healing rate and the limb salvage rate at 1 year after the surgery were evaluated. Preoperative and 3‐month postoperative digital subtraction angiography (DSA) were obtained. The level of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), epidermal growth factor (EGF) and platelet‐derived growth factor (PDGF) before surgery and on 1st, 4th, 11th, 18th, 28(th), and 35th days after surgery were measured. Operation time, intraoperative blood loss, postoperative complications, visual analog scale (VAS) pain score, skin temperature, Semmes‐weinstein monofilament (SWM), and ankle brachial index (ABI) were also assessed. RESULTS: The wound healing rate and the limb salvage rate were both 94.74% in the patients at 1 year after the surgery. DSA showed the thickening of the calf and foot arteries, clear visualization, and a rich vascular network. The levels of VEGF, bFGF, and PDGF on the 11th, 18th, 28(th), and 35th days after surgery were significantly higher than those before surgery (p < 0.05). The EGF level on the 18th, 28th, and 35th days after surgery was significantly higher than that before surgery (p < 0.05). Superficial wound complications occurred in one patient during the hospitalization. There was no movement area infection, skin flap necrosis, tibial fracture, loosening of the external fixator, or rupture in study. CONCLUSION: Transverse tibial bone transport can improve the blood circulation of the affected limbs, promote the healing of diabetic foot wounds, and reduce the amputation rate of the affected limbs. Transverse tibial bone transport can promote the healing of Wagner Stage 4 diabetic foot. John Wiley & Sons Australia, Ltd 2022-08-10 /pmc/articles/PMC9483085/ /pubmed/35946439 http://dx.doi.org/10.1111/os.13416 Text en © 2022 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Articles
Ou, Shuanji
Xu, Changpeng
Yang, Yang
Chen, Ya
Li, Wenjun
Lu, Hanyu
Li, Guitao
Sun, Hongtao
Qi, Yong
Transverse Tibial Bone Transport Enhances Distraction Osteogenesis and Vascularization in the Treatment of Diabetic Foot
title Transverse Tibial Bone Transport Enhances Distraction Osteogenesis and Vascularization in the Treatment of Diabetic Foot
title_full Transverse Tibial Bone Transport Enhances Distraction Osteogenesis and Vascularization in the Treatment of Diabetic Foot
title_fullStr Transverse Tibial Bone Transport Enhances Distraction Osteogenesis and Vascularization in the Treatment of Diabetic Foot
title_full_unstemmed Transverse Tibial Bone Transport Enhances Distraction Osteogenesis and Vascularization in the Treatment of Diabetic Foot
title_short Transverse Tibial Bone Transport Enhances Distraction Osteogenesis and Vascularization in the Treatment of Diabetic Foot
title_sort transverse tibial bone transport enhances distraction osteogenesis and vascularization in the treatment of diabetic foot
topic Clinical Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9483085/
https://www.ncbi.nlm.nih.gov/pubmed/35946439
http://dx.doi.org/10.1111/os.13416
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