Department of Orthopaedic Surgery, Jiangxi Provincial People's Hospital Affiliated To Nanchang University, 152 Ai Guo Road, Nanchang, 330006, Jiangxi, People's Republic of China.
Institute of Burn, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
J Orthop Surg Res. 2022 Mar 18;17(1):171. doi: 10.1186/s13018-022-03042-3.
Tibial cortex transverse distraction (TCTD) has been recently reported for the treatment of diabetic foot ulcers. Herein, we explored the characteristics of the impairments in static balance and plantar load distribution in patients.
We performed a retrospective study of 21 patients with diabetic foot ulcers who underwent TCTD, who were regularly followed up for > 1 year after surgery, and 20 healthy individuals (control group). A pressure platform was used to assess the standing balance functions of the lower extremities and the plantar load distribution.
One patient underwent amputation because of severe infection. In patient group, center of pressure (COP) ellipse sway area, COP path length and angle θ were all larger, compared with those of control group (250.15 ± 98.36 mm vs. 135.67 ± 53.21 mm, 145.15 ± 67.43 mm vs. 78.47 ± 34.15 mm, 39.75 ± 17.61° vs. 22.17 ± 14.15°), with statistically significant differences (P < 0.01). The average plantar load and backfoot load of the unaffected side was significantly larger than that of the affected side (58.4 ± 5.5% vs. 41.6 ± 5.5%, 45.3 ± 6.4% vs. 36.5 ± 5.6%), but they were similar for the two feet of members of the control group.
Although TCTD may represent an appropriate method for the treatment of diabetic foot ulcers, postoperative impairments in static balance and plantar load distribution remain in the long term. These potential long-term problems should be taken into account in further rehabilitation planning.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.
胫骨皮质横向牵张（TCTD）最近被报道用于治疗糖尿病足溃疡。在此，我们探讨了患者静态平衡和足底负荷分布损伤的特征。
我们对 21 例接受 TCTD 的糖尿病足溃疡患者进行了回顾性研究，这些患者在手术后定期随访>1 年，同时还纳入了 20 名健康个体作为对照组。使用压力平台评估下肢的站立平衡功能和足底负荷分布。
1 例患者因严重感染而截肢。与对照组相比，患者组的压力中心（COP）椭圆摆动面积、COP 轨迹长度和角度θ均更大（250.15±98.36mm 比 135.67±53.21mm，145.15±67.43mm 比 78.47±34.15mm，39.75±17.61°比 22.17±14.15°），差异有统计学意义（P<0.01）。未受影响侧的平均足底负荷和后足负荷明显大于受影响侧（58.4±5.5%比 41.6±5.5%，45.3±6.4%比 36.5±5.6%），但对照组的两个脚相似。
尽管 TCTD 可能是治疗糖尿病足溃疡的一种合适方法，但术后静态平衡和足底负荷分布的损伤仍长期存在。在进一步的康复计划中应考虑这些潜在的长期问题。
研究类型/证据水平：治疗性 III 级。
