单侧胫骨皮质横向骨搬运治疗双侧糖尿病足溃疡的疗效与安全性：一项倾向评分匹配研究。
Efficacy and safety of unilateral tibial cortex transverse transport on bilateral diabetic foot ulcers: A propensity score matching study.
作者信息
Qin Wencong, Nie Xinyu, Su Hongjie, Ding Yi, He Lihuan, Liu Kaibing, Hou Jun, Pan Kaixiang, He Liexun, Yang Sijie, Li Lisha, Yang Shenghui, Peng Xiao, Zhao Jinming, Guan Jack, Kuang Xiaocong, Hua Qikai
机构信息
Department of Bone and Joint Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China.
Guangxi Diabetic Foot Salvage Engineering Research Center, Guangxi Medical University, Nanning, Guangxi, 530021, China.
出版信息
J Orthop Translat. 2023 Sep 14;42:137-146. doi: 10.1016/j.jot.2023.08.002. eCollection 2023 Sep.
BACKGROUND
Tibial Cortex Transverse Transport (TTT) has been demonstrated to be an effective treatment for unilateral diabetic foot ulcers (UDFUs). However, this retrospective study was designed to compare the efficacy and safety of unilateral TTT on bilateral diabetic foot ulcers (BDFUs).
METHODS
This retrospective study included a review of patients with TTT treated from January 2017 to August 2019, Propensity Score Matching (PSM) was performed to compare patients with BDFUs to those with UDFUs. Ulcer healing, recurrence, and major amputation rates were evaluated at 1-year follow-up. Changes in foot vessels were assessed in the BDFUs group using computed tomography angiography (CTA).
RESULTS
A total of 140 patients with DFUs (106 UDFUs and 34 BDFUs) were included in the study. UDFUs and BDFUs were matched in a 1:1 ratio (34 in each group) using PSM. No significant difference was observed at 1-year-follow-up [91.2% (31/34) vs. 76.5% (26/34), OR 0.315 (95% CI 0.08 to 1.31), P = 0.10] and 6-month-follow-up [70.6% (24/34) vs. 50.0% (17/34), OR 0.85 (95% CI 0.15 to 1.13), P = 0.08] in two groups. Significant differences in rates of major amputation and recurrence between the groups (P > 0.05) were not observed. The BDFUs group appeared more angiogenesis of the foot by CTA after 8 weeks of operation.
CONCLUSION
Results of this study suggest that severe BDFUs can be effectively treated by unilateral TTT. TTT is easy to operate and effective, which may be a good alternative for treating severe BDFUs.
THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE
In previous retrospective clinical studies, TTT has demonstrated promising clinical outcomes in the management of diabetic foot ulcers. In this current study, we aim to investigate the potential use of TTT in treating distant tissue defects by evaluating the limited availability and safety of TTT for the management of bilateral diabetic foot. While additional basic and clinical research is necessary to fully elucidate the underlying mechanisms, our study offers insight into the potential therapeutic use of TTT for this condition.
背景
胫骨皮质横向骨搬运（TTT）已被证明是治疗单侧糖尿病足溃疡（UDFU）的有效方法。然而，本回顾性研究旨在比较单侧TTT治疗双侧糖尿病足溃疡（BDFU）的疗效和安全性。
方法
本回顾性研究纳入了2017年1月至2019年8月接受TTT治疗的患者，采用倾向得分匹配（PSM）方法将BDFU患者与UDFU患者进行比较。在1年随访时评估溃疡愈合、复发和大截肢率。使用计算机断层血管造影（CTA）评估BDFU组足部血管的变化。
结果
本研究共纳入140例糖尿病足溃疡患者（106例UDFU和34例BDFU）。使用PSM按1:1比例（每组34例）对UDFU和BDFU进行匹配。在1年随访时[91.2%（31/34）对76.5%（26/34），OR 0.315（95%CI 0.08至1.31），P = 0.10]和6个月随访时[70.6%（24/34）对50.0%（17/34），OR 0.85（95%CI 0.15至1.13），P = 0.08]两组间未观察到显著差异。两组间大截肢率和复发率无显著差异（P>0.05）。术后8周，BDFU组通过CTA显示足部血管生成更多。
结论
本研究结果表明，单侧TTT可有效治疗重度BDFU。TTT操作简便且有效，可能是治疗重度BDFU的良好选择。
本文的转化潜力
在以往的回顾性临床研究中，TTT在糖尿病足溃疡的治疗中已显示出有前景的临床结果。在本研究中，我们旨在通过评估TTT治疗双侧糖尿病足的有效性和安全性，来研究TTT在治疗远处组织缺损方面的潜在用途。虽然需要更多的基础和临床研究来充分阐明其潜在机制，但我们的研究为TTT在这种情况下的潜在治疗应用提供了见解。
Zotero 插件