Yang Yang, Chen Fang, Chen Yiguo, Wang Wei
Department of Orthopedics, People's Hospital of Yubei District, Chongqing, China.
Department of Infectious Disease, People's Hospital of Yubei District, Chongqing, China.
Front Surg. 2024 Oct 3;11:1396897. doi: 10.3389/fsurg.2024.1396897. eCollection 2024.
To investigate the efficacy of comparing tibia transverse transport (TTT) and periosteal distraction in treating diabetic foot ulcers.
A retrospective analysis of 19 patients with diabetic foot ulcers treated with both procedures between February 2020 and November 2022, 8 of whom were treated with the tibial transverse transfer technique (transfer group) and 11 with the osteochondral distraction technique (distraction group), was performed to compare and analyze the clinical efficacy of the two methods.
All wounds were healed in both groups, and the healing time ranged from 15 to 41days with a mean of 28d. The limb preservation rate was 100%. The operative time, intraoperative bleeding, and pain score in the operative area were significantly less in the distraction group than in the removal group, with statistically significant differences ( < 0.05). Intra-group comparison between the two groups of patients after surgery revealed that the skin temperature, ABI, TcPO2, SWM and VAS of the affected limb were significantly improved compared with those before surgery, and the difference was statistically significant ( < 0.05). The expression levels of VEGF, bFGF, EGF and PDGF were significantly higher than before surgery in both groups, and the difference was statistically significant ( < 0.05). No statistically significant differences were found in skin temperature, ABI, TcPO2, SWM, VAS, VEGF, bFGF, EGF and PDGF between the two groups at the corresponding time points preoperatively and postoperatively ( > 0.05).
The Periosteal distraction technique can significantly promote the healing of diabetic foot ulcers. It has the same efficacy as TTT in promoting the healing of diabetic foot ulcer wounds and improving the peripheral circulation of affected limbs. In addition, the periosteal distraction technique has the advantages of small trauma, simple operation, few complications, and convenient nursing care.
探讨胫骨横向搬移（TTT）与骨膜牵张治疗糖尿病足溃疡的疗效。
回顾性分析2020年2月至2022年11月期间采用这两种方法治疗的19例糖尿病足溃疡患者，其中8例采用胫骨横向转移技术（转移组），11例采用骨软骨牵张技术（牵张组），比较分析两种方法的临床疗效。
两组伤口均愈合，愈合时间为15至41天，平均28天。保肢率为100%。牵张组的手术时间、术中出血量及手术区域疼痛评分均明显少于切除组，差异有统计学意义（<0.05）。两组患者术后组内比较显示，患侧肢体皮肤温度、踝肱指数（ABI）、经皮氧分压（TcPO2）、皮肤微循环（SWM）及视觉模拟评分（VAS）较术前均明显改善，差异有统计学意义（<0.05）。两组血管内皮生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF）、表皮生长因子（EGF）及血小板衍生生长因子（PDGF）表达水平均较术前明显升高，差异有统计学意义（<0.05）。两组术前及术后相应时间点的皮肤温度、ABI、TcPO2、SWM、VAS、VEGF、bFGF、EGF及PDGF比较，差异均无统计学意义（>0.05）。
骨膜牵张技术能显著促进糖尿病足溃疡愈合。在促进糖尿病足溃疡创面愈合及改善患侧肢体周围血液循环方面与胫骨横向搬移疗效相当。此外，骨膜牵张技术具有创伤小、操作简单、并发症少及护理方便等优点。
