Clinical Effect Of Ilizarov Transverse Tibial Bone Transporting On Diabetic Foot

Objective:To provide better guidance for the treatment of patients with clinical diabetic foot(DF)and therefore benefit numerous doctors and patients,by analyzing the clinical efficacy of Ilizarov transverse tibial bone transporting in the treatment of DF and its effect on glucose metabolism,inflammatory index and coagulation function level,this thesis is expected.Methods: 60 DF patients with grade 3~4,who were treated in the Department of Endocrinology,orthopedics and Rehabilitation of Loudi Central Hospital during the period from August 2017 to December 2019,were selected.After basic routine treatment,They were randomly divided into two groups with the same size.Patients in the normal control group went on with the same routine treatment,while those in the experimental group received extra Ilizarov transverse tibial bone transporting on the basis of conventional treatment.Comparison was performed between these two groups of patients on multiple indications,including VAS pain score,the plantar skin temperature,determination of ankle brachial index,10 g nylon yarn,the limb salvage rate situation before and after treatment.Meanwhile,the postoperative complications was analyzed on both groups and data on fasting plasma glucose(FPG),blood sugar 2 hours after meal(2 h-PBG),glycosylated hemoglobin(HbA1c),white blood cell count(WBC),blood sedimentation(ESR),c-reactive protein(CRP),D2-polymers(D-D),fibrinogen(FIB)level were compared.Results: 1.There were no significant statistic difference found in age,Wagner grade,sex,course of BMI,diabetes,course of DFU and complications of other diabetes in the study group(p >0.05).Originally,60 subjects were equally divided into 2 groups 55 could be evaluated,28 in experimental group and 27 in control group respectively.2.Clinical efficacy index analysis: After treatment,the VAS score,skin temperature,10 g nylon thread test,ankle brachial index,ulcer healing rate and limb retention rate of the experimental group were remarkable better than those of the control group(p <0.05).Three patients in the experimental group had redness and swelling of the skin around the nail channel during the course of treatment antibiotic treatment.All patients had no skin necrosis,bone disunion,fracture,osteomyelitis,chronic pain,loosening of external fixator and recurrence of ulcers in the short term,which is satisfactory achievement.3.The changes of glucose metabolism,inflammatory index and coagulation function: after treatment,the FPG、2h-PBG、HbA1c、WBC、ESR、CRP、D-D、FIB level of the study group decreased compared with that before treatment(p <0.05).Compared with that before treatment,no significant statistic change is found in the FPG、2h-PBG、HbA1c of the control group compared with that before treatment,while the WBC、ESR、CRP、D-D、FIB level decreased(p <0.05).The levels of the FPG、2h-PBG、HbA1c、WBC、ESR、CRP、D-D、FIB of experimental group were lower than those of the control group(p <0.05).Conclusion: 1.Ilizarov transverse tibial bone transporting can alleviate the clinical symptoms of DF patients,strengthen blood supply and peripheral nerve function of lower extremities,accelerate the healing of ulcers,improve the rate of limb preservation,and be safer and more effective as well.2.Ilizarov transverse tibial bone transporting can assist glucose metabolism,reduce inflammatory reactions,and improve coagulation function in DF patients.