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腓骨横向搬移技术治疗糖尿病足溃疡的疗效观察

[Observation on the curative effect of fibula transverse transport technique in the treatment of diabetic foot ulcer].

作者信息

Yu Z R, Song T, Zhang W T, Cong F, Tian X N, Fan J Z, Liu Y F

机构信息

Department of Bone Microsurgery, Hong Hui Hospital, Xi'an Jiaotong University, Xi'an 710054, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2021 Oct 26;101(39):3248-3252. doi: 10.3760/cma.j.cn112137-20210418-00931.

Abstract

To investigate the clinical effect of fibula transverse transport technique in the treatment of diabetic foot ulcer. Nine patients (7 males and 2 females) with diabetic foot ulcer were treated with fibula transverse transport technique from September 2017 to September 2020. The mean age was (55±9) years (ranged from 43 to 66 years). In terms of Wagner classification, 2 cases were in grade 2, 5 cases were in grade 3, and the other 2 cases were in grade 4. All of the cases involved ischemic ulcers or ischemic-nerve ulcers. The transcutaneous oxygen pressure (TcPO) of the dorsal foot of the affected limb was measured, with the ulcer healing and TcPO changes recorded at follow-up. All the 9 patients were followed up for (23±12) months (3 to 38 months). It was found that all patients with foot ulcers were cured within (4.2±1.9) months (2 to 8 months), and all the patients obtained limb salvage. Besides, there was no serious complications occurred, such as skin necrosis and needle tract infection. Before the operation, the TcPO of the affected foot was (28.6±3.8) mmHg(1 mmHg=0.133 kPa), while it was (35.0±5.6) mmHg three months after operation (<0.05). The technique of fibula transverse transport can effectively improve the microcirculation function of diabetic foot, and it can promote the healing of the ulcer with few complications.

摘要

探讨腓骨横向骨搬移技术治疗糖尿病足溃疡的临床效果。2017年9月至2020年9月,采用腓骨横向骨搬移技术治疗9例糖尿病足溃疡患者(男7例,女2例)。平均年龄为(55±9)岁(43~66岁)。按Wagner分级,2级2例,3级5例,4级2例。所有病例均为缺血性溃疡或缺血-神经溃疡。测量患肢足背经皮氧分压(TcPO),随访记录溃疡愈合情况及TcPO变化。9例患者均获随访,随访时间为(23±12)个月(3~38个月)。结果显示,所有足溃疡患者均在(4.2±1.9)个月(2~8个月)内治愈,均保肢成功。此外,未发生皮肤坏死、针道感染等严重并发症。术前患足TcPO为(28.6±3.8)mmHg(1 mmHg = 0.133 kPa),术后3个月为(35.0±5.6)mmHg(P<0.05)。腓骨横向骨搬移技术能有效改善糖尿病足的微循环功能,促进溃疡愈合,且并发症少。

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