Efficacy and safety of tibial cortex transverse transport for diabetic foot: A protocol for systematic review and meta-analysis

Guo, Jiaxing; Bao, Huhe; Lideer,; Ni, Xiyu; Zhao, Yaxin; Sun, Guanwen

doi:10.1371/journal.pone.0277269

Cited by 2 publications

(2 citation statements)

References 26 publications

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“…However, as these conventional methods often fail to enhance blood supply to lower limbs, patients’ ulcers often encounter challenges in achieving smooth healing. Although percutaneous transluminal angioplasty can restore patency in some major lower limb vessels, it cannot reconstruct the peripheral microcirculation, leading to limited effectiveness ( 7 ). At present, surgeons and DFU patients are faced with the problem that patients cannot achieve definite curative effects after paying huge medical expenses.…”

Section: Introductionmentioning

confidence: 99%

Modified tibial cortex transverse transport for diabetic foot ulcers with Wagner grade ≥ II: a study of 98 patients

Liu,

Yao,

et al. 2024

Front. Endocrinol.

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BackgroundDiabetic foot ulcers constitute a substantial healthcare burden on a global scale and present challenges in achieving healing. Our objective was to assess the efficacy of modified tibial cortex transverse transport surgery in managing refractory diabetic foot ulcers.MethodsWe retrospectively analyzed clinical data from 98 patients suffering from diabetic foot ulcers classified as Wagner grade ≥II who were admitted to our medical facility between January 2020 and June 2022. All the patients were treated by modified tibial cortex transverse transport surgery, wherein the osteotomy scope was reduced to two rectangular bone windows measuring 1.5cm × 1.5cm each. Record the patient’s general information and ulcer healing time; ulcer area, ankle-brachial index, WIFi classification, and visual analogue scale before and 3 months following the surgical intervention.ResultsThe average duration of diabetes of 98 patients with diabetic foot ulcer was 20.22 ± 8.02 years, 52 patients had more than one toe gangrene on admission. The postoperative wound healing rate was 95.83% and the average healing time was 53.18 ± 20.18 days. The patients showed significant improvement in ankle-brachial index, WIFi classification, and visual analogue scale at 3 months postoperatively compared to preoperatively, with statistically significant differences (P< 0.05). Eight patients experienced complications, and the incidence of complications was 8.16%. Throughout the follow-up period, there were no instances of ulcer recurrence noted.ConclusionModified tibial cortex transverse transport surgery demonstrates effectiveness in the management of diabetic foot ulcers by enhancing lower limb microcirculation and facilitating the process of wound healing.

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Section: Introductionmentioning

confidence: 99%

Modified tibial cortex transverse transport for diabetic foot ulcers with Wagner grade ≥ II: a study of 98 patients

Liu,

Yao,

et al. 2024

Front. Endocrinol.

View full text Add to dashboard Cite

show abstract

“…However, traditional treatment methods, such as surgical debridement, free-flap transplantation, infection control, and revascularization [ 5 – 9 ], often fail to effectively cure intractable ulcers [ 10 ]. Off-loading surgery, such as osteotomies, achieved through bone resection, can effectively rebalance plantar pressures, thereby minimizing mechanical damage and lowering the likelihood of ulcer development [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Learning curve of tibial cortex transverse transport: a cumulative sum analysis

Liu,

Yao,

et al. 2023

J Orthop Surg Res

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Objective This study aimed to describe the learning curve of surgeons performing tibial cortex transverse transport (TTT) and explore its safety and effectiveness during the initial stages of surgeon’s learning. Methods The clinical data of patients with diabetic foot ulcers classified as Wagner grade ≥ 2, who underwent TTT at our hospital from January 2020 to July 2021, were included in this retrospective analysis. The same physician performed all procedures. Patients were numbered according to the chronological order of their surgery dates. The cumulative sum and piecewise linear regression were used to evaluate the surgeon's learning curve, identify the cut-off point, and divide the patients into learning and mastery groups. A minimum follow-up period of 3 months was ensured for all patients. Baseline data, perioperative parameters, complications, and efficacy evaluation indicators were recorded and compared between the two groups. Results Sixty patients were included in this study based on the inclusion and exclusion criteria. After completing 20 TTT surgeries, the surgeon reached the cut-off point of the learning curve. Compared to the learning group, the mastery group demonstrated a significant reduction in the average duration of the surgical procedure (34.88 min vs. 54.20 min, P < 0.05) along with a notable decrease in intraoperative fluoroscopy (9.75 times vs. 16.9 times, P < 0.05) frequency, while no significant difference was found regarding intraoperative blood loss (P = 0.318). Of the patients, seven (11.7%) experienced complications, with three (15%) and four cases (10%) occurring during the learning phase and the mastery phase, respectively. The postoperative ulcer area was significantly reduced, and the overall healing rate was 94.8%. Significant improvements were observed in postoperative VAS, ABI, and WIFI classification (P < 0.05). There were no significant differences in the occurrence of complications or efficacy indicators between the learning and mastery groups (P > 0.05). Conclusion Surgeons can master TTT after completing approximately 20 procedures. TTT is easy, secure, and highly efficient for treating foot ulcers. Furthermore, TTT’s application by surgeons can achieve almost consistent clinical outcomes in the initial implementation stages, comparable to the mastery phase.

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Efficacy and safety of tibial cortex transverse transport for diabetic foot: A protocol for systematic review and meta-analysis

Cited by 2 publications

References 26 publications

Modified tibial cortex transverse transport for diabetic foot ulcers with Wagner grade ≥ II: a study of 98 patients

Modified tibial cortex transverse transport for diabetic foot ulcers with Wagner grade ≥ II: a study of 98 patients

Learning curve of tibial cortex transverse transport: a cumulative sum analysis

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