RETRACTED ARTICLE: Triplanar osteotomy combined with proximal tibial transverse transport to accelerate healing of recalcitrant diabetic foot ulcers
Abstract Background Management of recalcitrant diabetic foot ulcers remains challenging. Tibial transverse transport (TTT) is an effective method for enhancing the healing of foot ulcers. This retrospective study reports a novel triplanar osteotomy in the tibia and assesses the clinical outcomes of...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-022-03410-z |
| _version_ | 1797414485528412160 |
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| author | Jia Xu Shanyu Li Yunchu Sun Bingbo Bao Tianhao Zhu Qinglin Kang Xianyou Zheng Gen Wen |
| author_facet | Jia Xu Shanyu Li Yunchu Sun Bingbo Bao Tianhao Zhu Qinglin Kang Xianyou Zheng Gen Wen |
| author_sort | Jia Xu |
| collection | DOAJ |
| description | Abstract Background Management of recalcitrant diabetic foot ulcers remains challenging. Tibial transverse transport (TTT) is an effective method for enhancing the healing of foot ulcers. This retrospective study reports a novel triplanar osteotomy in the tibia and assesses the clinical outcomes of TTT for diabetic foot ulcers. Methods Fifty-nine patients with recalcitrant diabetic foot ulcers were divided into the TTT (32 patients) and control (27 patients) groups. In the TTT group, the patients underwent triplanar osteotomy of the proximal tibia, followed by 2 weeks of medial distraction and 2 weeks of lateral distraction. In the control group, the patients received conventional management, including debridement, revascularization, and reconstruction. Ulcer healing and healing time, amputation, recurrence, and complications were assessed at an 18-month follow-up visit. Computed tomography angiography (CTA) was used to evaluate vessel changes in the lower limbs of patients in the TTT group. Results The TTT group was superior to the control group in the healing rate (90.6% [29/32] vs. 66.7% [18/27]) and the healing time (4.6 ± 1.7 months vs. 7.4 ± 2.5 months), respectively. The proportions of amputation and recurrence in the TTT group were lower than that in the control group, without statistical difference. After triplanar osteotomy and transverse distraction, CTA demonstrated an increase in small vessels in the wound and ipsilateral limb. All patients achieved satisfactory union of the osteotomized bone fragment after removal of the external fixator. Conclusions Triplanar osteotomy combined with proximal tibial transverse distraction accelerates wound healing and limb salvage caused by severe and recalcitrant diabetic foot ulcers. Triplanar osteotomy not only increases the bone contact area, which is beneficial for rapid bone reconstruction, but also preserves the vascularization of the bone fragment and substantially facilitates capillary angiogenesis during distraction. These results suggest that triplanar osteotomy followed by tibial transverse distraction is an effective method for treating diabetic foot ulcers. |
| first_indexed | 2024-03-09T05:33:57Z |
| format | Article |
| id | doaj.art-e8dc07ef7f6042d2a73fc06057f700f0 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-03-09T05:33:57Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-e8dc07ef7f6042d2a73fc06057f700f02023-12-03T12:30:44ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-12-011711710.1186/s13018-022-03410-zRETRACTED ARTICLE: Triplanar osteotomy combined with proximal tibial transverse transport to accelerate healing of recalcitrant diabetic foot ulcersJia Xu0Shanyu Li1Yunchu Sun2Bingbo Bao3Tianhao Zhu4Qinglin Kang5Xianyou Zheng6Gen Wen7Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalAbstract Background Management of recalcitrant diabetic foot ulcers remains challenging. Tibial transverse transport (TTT) is an effective method for enhancing the healing of foot ulcers. This retrospective study reports a novel triplanar osteotomy in the tibia and assesses the clinical outcomes of TTT for diabetic foot ulcers. Methods Fifty-nine patients with recalcitrant diabetic foot ulcers were divided into the TTT (32 patients) and control (27 patients) groups. In the TTT group, the patients underwent triplanar osteotomy of the proximal tibia, followed by 2 weeks of medial distraction and 2 weeks of lateral distraction. In the control group, the patients received conventional management, including debridement, revascularization, and reconstruction. Ulcer healing and healing time, amputation, recurrence, and complications were assessed at an 18-month follow-up visit. Computed tomography angiography (CTA) was used to evaluate vessel changes in the lower limbs of patients in the TTT group. Results The TTT group was superior to the control group in the healing rate (90.6% [29/32] vs. 66.7% [18/27]) and the healing time (4.6 ± 1.7 months vs. 7.4 ± 2.5 months), respectively. The proportions of amputation and recurrence in the TTT group were lower than that in the control group, without statistical difference. After triplanar osteotomy and transverse distraction, CTA demonstrated an increase in small vessels in the wound and ipsilateral limb. All patients achieved satisfactory union of the osteotomized bone fragment after removal of the external fixator. Conclusions Triplanar osteotomy combined with proximal tibial transverse distraction accelerates wound healing and limb salvage caused by severe and recalcitrant diabetic foot ulcers. Triplanar osteotomy not only increases the bone contact area, which is beneficial for rapid bone reconstruction, but also preserves the vascularization of the bone fragment and substantially facilitates capillary angiogenesis during distraction. These results suggest that triplanar osteotomy followed by tibial transverse distraction is an effective method for treating diabetic foot ulcers.https://doi.org/10.1186/s13018-022-03410-zTriplanar osteotomyTibial transverse transportDiabetic foot ulcers |
| spellingShingle | Jia Xu Shanyu Li Yunchu Sun Bingbo Bao Tianhao Zhu Qinglin Kang Xianyou Zheng Gen Wen RETRACTED ARTICLE: Triplanar osteotomy combined with proximal tibial transverse transport to accelerate healing of recalcitrant diabetic foot ulcers Journal of Orthopaedic Surgery and Research Triplanar osteotomy Tibial transverse transport Diabetic foot ulcers |
| title | RETRACTED ARTICLE: Triplanar osteotomy combined with proximal tibial transverse transport to accelerate healing of recalcitrant diabetic foot ulcers |
| title_full | RETRACTED ARTICLE: Triplanar osteotomy combined with proximal tibial transverse transport to accelerate healing of recalcitrant diabetic foot ulcers |
| title_fullStr | RETRACTED ARTICLE: Triplanar osteotomy combined with proximal tibial transverse transport to accelerate healing of recalcitrant diabetic foot ulcers |
| title_full_unstemmed | RETRACTED ARTICLE: Triplanar osteotomy combined with proximal tibial transverse transport to accelerate healing of recalcitrant diabetic foot ulcers |
| title_short | RETRACTED ARTICLE: Triplanar osteotomy combined with proximal tibial transverse transport to accelerate healing of recalcitrant diabetic foot ulcers |
| title_sort | retracted article triplanar osteotomy combined with proximal tibial transverse transport to accelerate healing of recalcitrant diabetic foot ulcers |
| topic | Triplanar osteotomy Tibial transverse transport Diabetic foot ulcers |
| url | https://doi.org/10.1186/s13018-022-03410-z |
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