[Transverse tibial bone movement for the treatment of diabetic foot ulcers].

OBJECTIVE

To explore Ilizarov technique in treating diabetic foot ulcers with transverse tibial bone movement.

METHODS

From July 2013 to March 2017, 20 patients with diabetic foot ulcers were treated by transverse tibial bone movement, including 14 males and 6 females aged from 46 years to 61 years with an average of (51.6±6.8) years old. According to Wagner's criteria, 5 patients were Grade III and 15 patients were Grade IV. Amputation level, ulcer healing time, VAS score, foot skin temperature before and after operation, vascular recanalization or reconstruction were observed by CTA of affected limb.

RESULTS

Twenty patients followed up from 12 to 58 months with an average of 22.4 months. Foot ulcers were healed from 6 to 18 weeks with an average of (13.2±3.7) weeks. There was no upper movement in the level of necrosis and amputation, and pain was relieved. VAS score was decreased from 5.6±0.8 before operation to 0.9±0.4 after operation at 1 year; skin temperature was increased from(27.9±1.1)°C before operation to (30.9±1.1)°C after operation at 1 year. CTA indicated vessel occluded artery was dredged, and the number of micro-vessel was increased, and vasoganglion of foot was reconstructed.

CONCLUSIONS

Transverse tibial bone movement by Ilizarov technique could promote angiogenesis, reconstructive of vasoganglion to improve blood circulation of diabetic patients with foot ulcers, promote healing of ulcers, so it is suitable for diabetic patients with foot ulcers occurred on microangiopathy. For patients with severe stenosis or occlusion of trunk artery should be used carefully or combination with interventional therapy.