A Study Of Ilizarov Transverse Tibial Bone Transport Clinical Efficacy Of Diabetic Foot Ulcer

Objective:To investigate the clinical efficacy of Ilizarov transverse tibial bone transport for diabetic foot ulcer.Methods:Select 20 inpatient cases of diabetic foot ulcer in endocrinology or bone and joint department in the First Affiliated Hospital of Guangxi Medical University between February 2015 to December 2015. 18 males and 2 females.Left foot 9 patients and right foot 11 patients. 4 cases with Wagner grade 2, 5 cases with Wagner grade 3 and 11 cases with Wagner grade 4.Agressive comprehensive medical therapy were essential. All cases were treated with Ilizarov transverse tibial bone transport after signed a operation consent.5 cases with severe infection had used vacuum sealing drainage(VSD) before operation and 4 cases undergoing toe amputation simultaneously. 3 to 5 days later upward the external fixation (1mm per day,3 steps per day) lasting 14 days and then turn it back as before. All patients were followed up to observe some indexes and evaluate its efficacy 4 to 12 weeks later. Observation indexes: foot ulcer healing、pain score、cold sensation score、skin temperature、TCSS score and CTA in lower extremity artery.Results:1、20 patients were followed up, 17 feet with ulcer showed healing after transverse tibial bone transport within eight weeks, 1 case with wound dehiscence because of all toes amputation and suffered from soft tissue infection by using herbal medicine, then the wound healing 1 month later by readmission to underwent surgical debridement and skin traction.2 patients after bone transport only 4weeks were observed granulation tissue growing well in the wound.2、16 patients complete relevant index detection successfully. The cold sensation score and TCSS score in affected limbs decreased, skin temperature evaluated, there were significant differences between before and after treatment(P<0.05) ,but no significant difference in cold sensation score was found between before and after treatment (P>0.05).3、5 patients had completed the CTA in lower limbs and angiogenesis were observed in affected limbs.Conclusions:1、Ilizarov transverse tibial bone transport has good clinical efficacy on diabetic foot ulcer. The operation is simple and with less trauma and adverse reactions, it can significantly reduce the amputation rate, alleviate the suffering of patients and improve life quality.2、The efficacy on diabetic foot ulcer with Ilizarov transverse tibial bone transport is closely associated with positive medical comprehensive treatment,more attention should be taken to multidisciplinary cooperation.