Transverse Tibial Transport & Limb Salvage
The research behind transverse tibial transport — from Ilizarov's tension-stress principle to modern diabetic-foot, angiogenesis and limb-salvage studies.
74 REFERENCES · ORGANIZED BY TOPIC
Transverse tibial transport did not appear out of nowhere. Its clinical story stretches from distraction osteogenesis and ischemic-limb work to modern studies of diabetic foot ulcer healing, perfusion, angiogenesis and limb salvage. We organized the literature below and added a short plain-English FAN Takeaway explaining what each paper contributes to the conversation.
How to read this guide
This is a literature guide, not a treatment recommendation. The TTT literature includes encouraging clinical cohorts and mechanistic work, but much of the evidence remains non-randomized and comes from centers with substantial experience using the technique. Several authors explicitly call for larger randomized trials. Standard diabetic-foot care — infection control, vascular assessment and revascularization when indicated, debridement, off-loading, wound management and multidisciplinary care — remains the foundation.
In this guide
TTT — Clinical Evidence
Modified tibial cortex transverse transport for diabetic foot ulcers with Wagner grade ≥ II: a study of 98 patients.
Liu J, et al. (2024) Frontiers in Endocrinology 15.
FAN Takeaway: A 98-patient clinical study evaluating a modified TTT technique in Wagner grade II or worse diabetic foot ulcers. Useful as a more recent look at how the procedure is being refined and applied beyond the earliest clinical series.
Outcomes of integrated surgical wound treatment mode based on tibial transverse transport for diabetic foot wound.
Chang S, et al. (2023) Frontiers in Surgery 9.
FAN Takeaway: A small 13-patient series combining TTT with debridement, induced membrane techniques, negative-pressure therapy and skin grafting. It supports viewing TTT as part of a broader limb-salvage pathway rather than a stand-alone wound treatment.
Effectiveness of transverse tibial bone transport in treatment of diabetic foot ulcer: A systematic review and meta-analysis.
Hu X-X, et al. (2023) Frontiers in Endocrinology 13:1095361.
FAN Takeaway: A meta-analysis of seven studies involving 818 patients. The pooled data favored TTT for ulcer healing and limb salvage, but the authors also flagged tibial fracture, pin-site infection and anterior tibial skin necrosis as complications and called for caution in interpreting the evidence.
A novel and alternative treatment method for large heel ulceration in diabetic patients: Proximal tibial cortex transverse distraction.
Jianda X, et al. (2023) International Wound Journal 20(3):732–739.
FAN Takeaway: A retrospective series of 21 diabetic patients with large heel ulcers. All wounds healed and all limbs were salvaged in this small cohort, making it an encouraging but still limited study in a particularly difficult ulcer location.
Efficacy and safety of unilateral tibial cortex transverse transport on bilateral diabetic foot ulcers: A propensity score matching study.
Qin W, et al. (2023) Journal of Orthopaedic Translation 42:137–146.
FAN Takeaway: A retrospective propensity-matched study asking whether unilateral TTT can influence bilateral diabetic foot ulcers. The work is interesting because it suggests the biologic effect may not be purely local, although this remains an area needing confirmation.
Transverse tibial bone transfer in the treatment of diabetes foot ulcer: A pilot study.
Wen R, et al. (2023) Diabetes, Metabolic Syndrome and Obesity 16:2005–2012.
FAN Takeaway: A pilot clinical study of transverse tibial bone transfer for diabetic foot ulceration. It adds to the growing body of early clinical experience but should be interpreted as exploratory rather than definitive evidence.
Effect of tibial cortex transverse transport in patients with recalcitrant diabetic foot ulcers: A prospective multicenter cohort study.
Chen Y, et al. (2022) Journal of Orthopaedic Translation 36:194–204.
FAN Takeaway: One of the more important clinical papers in the TTT literature: a prospective multicenter cohort across seven centers in recalcitrant diabetic foot ulcers. It was designed to test whether the favorable single-center experience translated across institutions and also examined quality-of-life outcomes.
Tibial cortex transverse transport facilitating healing in patients with recalcitrant non-diabetic leg ulcers.
Nie X, et al. (2021) Journal of Orthopaedic Translation 27:1–7.
FAN Takeaway: A comparative study extending TTT beyond diabetic wounds to recalcitrant non-diabetic leg ulcers. The TTT group healed faster than conventionally treated controls, suggesting the proposed perfusion effect may have broader limb-salvage relevance.
Modified tibial transverse transport technique for the treatment of ischemic diabetic foot ulcer in patients with type 2 diabetes.
Yuan Y, et al. (2021) Journal of Orthopaedic Translation 29:100–105.
FAN Takeaway: Evaluates a modified TTT technique in ischemic diabetic foot ulcers. The paper is useful for understanding how surgeons have continued to alter the original procedure to reduce morbidity while preserving the proposed biologic effect.
Treatment experiences of 516 cases of diabetic foot treated with tibial transverse transport.
Hua Q, et al. (2020) Chinese Journal of Reparative and Reconstructive Surgery 34(8):959–963.
FAN Takeaway: A large Chinese experience summarizing more than 500 TTT-treated diabetic foot cases and reporting a limb-salvage rate of 96.1%. It is important for scale and historical experience, although it is not a randomized comparison.
Proximal Tibial Cortex Transverse Distraction Facilitating Healing and Limb Salvage in Severe and Recalcitrant Diabetic Foot Ulcers.
Chen Y, Lu W, et al. (2019/2020) Clinical Orthopaedics and Related Research 478(4):836–851.
FAN Takeaway: A key comparative clinical paper. In 136 TTT patients versus a historical-control group, the authors reported higher healing, lower major-amputation rates and lower recurrence, along with increased small-vessel density and perfusion. The authors explicitly called for randomized trials to confirm the findings.
Application of Ilizarov transverse tibial bone transport and microcirculation reconstruction in the treatment of chronic ischemic diseases in lower limbs.
Zuo Q, et al. (2018) Experimental and Therapeutic Medicine 16:1355–1359.
FAN Takeaway: An earlier clinical application of transverse tibial transport for chronic lower-extremity ischemic disease. It helps connect modern TTT for diabetic foot disease with the technique's vascular and limb-ischemia roots.
The therapy of transverse tibial bone transport and vessel regeneration operation on thromboangiitis obliterans.
Qu L, et al. (2001) Zhonghua Yixue Zazhi 81(10):622–624.
FAN Takeaway: One of the foundational Chinese reports applying transverse tibial bone transport to thromboangiitis obliterans. This is part of the clinical lineage that eventually led to modern TTT use in diabetic foot disease.
No link in the source bibliography
TTT — Mechanism, Biology & Technique
Impact of tibial transverse transport in tissue regeneration and wound healing with perspective on diabetic foot ulcers.
Mukherjee S, Im S-S. (2024) World Journal of Diabetes 15(5):810–813.
FAN Takeaway: A short perspective on why TTT may promote tissue regeneration and wound healing. Good background for readers who want the biologic rationale without diving directly into surgical series.
Tibial cortex transverse transport potentiates diabetic wound healing via activation of SDF-1/CXCR4 signaling.
Ou S, et al. (2023) PeerJ.
FAN Takeaway: A mechanistic study linking TTT with increased endothelial progenitor cells and activation of the SDF-1/CXCR4 pathway. It supports a plausible biologic pathway for neovascularization and wound healing rather than simply reporting clinical outcomes.
Learning curve of tibial cortex transverse transport: A cumulative sum analysis.
Liu J-P, et al. (2023) Journal of Orthopaedic Surgery and Research 18:650.
FAN Takeaway: A 60-patient learning-curve analysis examining how surgeon proficiency develops with TTT. Particularly relevant as the technique spreads: it addresses not just whether TTT can work, but what adoption may look like in the hands of a new operator.
Transverse Tibial Bone Transport Enhances Distraction Osteogenesis and Vascularization in the Treatment of Diabetic Foot.
Ou S, Qi Y, et al. (2022) Orthopaedic Surgery 14(9):2170–2179.
FAN Takeaway: Explores the relationship between transverse tibial transport, distraction osteogenesis and vascularization. It contributes to the biologic argument that the procedure may alter perfusion and regenerative activity beyond the transported bone itself.
Tibial cortex transverse transport accelerates wound healing via enhanced angiogenesis and immunomodulation.
Yang Y, Li G, et al. (2022) Bone & Joint Research 11(4):189–199.
FAN Takeaway: A preclinical mechanistic study showing greater blood flow, neovascularization and M2-macrophage activity with TTT in an experimental model. It is an important mechanistic bridge between Ilizarov biology and the clinical wound-healing claims.
Twenty years development of tibial cortex transverse transport surgery in PR China.
Liu Z, Xu C, et al. (2022) Orthopaedic Surgery 14(6):1034–1048.
FAN Takeaway: A useful history and technique review tracing two decades of TTT evolution in China. It describes changes in fixator design, incision and osteotomy size, distraction protocols and proposed mechanisms including vascular regeneration, macrophage polarization and stem-cell mobilization.
Transverse Kallusdistraktion — Neue Chancen für den Extremitätenerhalt?
Thaller PH, et al. (2022) Unfallchirurg 125(4):282–287.
FAN Takeaway: A German-language review discussing transverse callus distraction as a potential limb-salvage strategy. It reflects growing international interest outside the original Chinese experience.
The emerging role of tibial cortex transverse transport in the treatment of chronic limb ischemic diseases.
Guangwei L, et al. (2020) Journal of Orthopaedic Translation 25:17–24.
FAN Takeaway: A review positioning TTT as an extension of distraction osteogenesis for chronic limb ischemic disease. It lays out the proposed link between distraction, neovascularization, improved perfusion and wound healing.
An update to the advances in understanding distraction histogenesis: From biological mechanisms to novel clinical applications.
Kong L-C, et al. (2020) Journal of Orthopaedic Translation 25:3–10.
FAN Takeaway: A broad review of distraction histogenesis, moving from the classic tension-stress concept into newer tissue-regeneration applications. Helpful for understanding the biologic framework in which TTT sits.
How to perform minimal invasive tibial cortex transport surgery.
Li G, Ling SKK, et al. (2020) Journal of Orthopaedic Translation 25:28–32.
FAN Takeaway: A technique-focused paper describing a minimally invasive approach to tibial cortex transport. This one is especially relevant to the obvious next question for the U.S. market: how small, simple and reproducible can the operation become?
Treatment of diabetic foot with the transverse tibial bone transport guided by three-dimensional printing guide plates.
Zhang Y-W, et al. (2020) Asian Journal of Surgery 43:832–834.
FAN Takeaway: Describes the use of 3D-printed guides to assist transverse tibial transport. It is an early example of instrumentation being used to standardize and simplify the procedure.
A network of trans-cortical capillaries as mainstay for blood circulation in long bones.
Grüneboom A, Culemann S, et al. (2019) Nature Metabolism 1(2):236–250.
FAN Takeaway: A basic-science study identifying a dense trans-cortical capillary network in long bones. While not a TTT study, it provides important anatomic context for theories linking cortical manipulation with changes in bone and limb microcirculation.
The history, evolution and basic science of osteotomy techniques.
Dabis J, et al. (2017) Strategies in Trauma and Limb Reconstruction 12:169–180.
FAN Takeaway: A review of osteotomy biology and technique. It provides useful background for understanding why corticotomy design, soft-tissue preservation and stability matter in distraction-based procedures.
Growth Factors in Human Serum During Operative Tibial Lengthening With the Ilizarov Method.
Stogov MV, et al. (2013) Journal of Orthopaedic Research.
FAN Takeaway: Examines systemic growth-factor changes during Ilizarov tibial lengthening. It supports the broader idea that distraction osteogenesis generates biologic effects extending beyond simple mechanical bone movement.
Osteogenesis and Angiogenesis in Regenerating Bone during Transverse Distraction.
Matsuyama J, et al. (2005) Clinical Orthopaedics and Related Research 433:243–250.
FAN Takeaway: An important pre-TTT basic-science paper showing that transverse distraction is accompanied by both new-bone formation and angiogenesis. It is one of the biologic building blocks underlying the modern procedure.
Growth factors in distraction osteogenesis — Immuno-histological pattern of TGF-β1 and IGF-I in human callus induced by distraction osteogenesis.
Eingartner C, Coerper S, Koveker G, et al. (1999) International Orthopaedics 23:253–259.
FAN Takeaway: Demonstrates growth-factor activity in human distraction callus. It is background evidence for the highly active regenerative environment created by distraction osteogenesis.
No link in the source bibliography
The tension-stress effect on the genesis and growth of tissues. Part I.
Ilizarov GA. (1989) Clinical Orthopaedics and Related Research 238:249–281.
FAN Takeaway: The foundational biologic concept behind distraction osteogenesis: gradual, controlled tension can stimulate growth and regeneration in bone and surrounding tissues. Modern TTT is fundamentally an extension of this principle.
Diabetic Foot — Burden, Outcomes & Limb Salvage
Burden of Infected Diabetic Foot Ulcers on Hospital Admissions and Costs in a Third-Level Center.
Da Ros R, et al. (2024) Diabetology 5:141–150.
FAN Takeaway: Quantifies the hospital and cost burden created by infected diabetic foot ulcers. It provides current context for why therapies that prevent repeated admissions, major surgery or amputation attract so much clinical and economic interest.
Diabetic foot ulcers. A review.
Armstrong DG, et al. (2023) JAMA 330(1):62–75.
FAN Takeaway: A modern overview of diabetic foot ulcer epidemiology, diagnosis, treatment and recurrence. A strong general-reference paper for understanding the population in which TTT is being proposed.
Economic Costs of Diabetes in the U.S. in 2022.
Parker ED, et al. (2023) Diabetes Care.
FAN Takeaway: A major U.S. economic analysis of diabetes. Not specific to TTT, but it establishes the enormous cost environment surrounding diabetes and its complications.
Global estimates of diabetes-related amputations incidence in 2010–2020: A systematic review and meta-analysis.
Ezzatvar Y, et al. (2022) Diabetes Research and Clinical Practice 195:110194.
FAN Takeaway: A global systematic review of diabetes-related amputation incidence. Useful for framing limb salvage as a worldwide problem rather than a niche wound-care issue.
Observed impact of skin substitutes in lower extremity diabetic ulcers: lessons from the Medicare Database (2015–2018).
Armstrong DG, et al. (2021) Journal of Wound Care 30(7):5–16.
FAN Takeaway: A Medicare-database analysis examining real-world use of skin substitutes in diabetic lower-extremity ulcers. It illustrates how wound-care interventions are evaluated outside controlled trials and how treatment utilization can influence outcomes and cost.
No link in the source bibliography
The art of medicine — Diabetes, race, and amputations.
Mizelle RM Jr. (2021) The Lancet 397:1256–1257.
FAN Takeaway: A perspective on the relationship among diabetes, disparities and amputation. It is a reminder that limb-salvage outcomes are shaped by access, socioeconomic factors and health-system inequities as well as technology.
No link in the source bibliography
Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer.
Armstrong DG, et al. (2020) Journal of Foot and Ankle Research 13:16.
FAN Takeaway: A widely cited comparison showing how severe the long-term mortality and cost burden of diabetic foot complications can be. It is one of the clearest papers for explaining why diabetic foot disease deserves to be treated as a major systemic health problem.
Lower extremity amputations and long-term outcomes in diabetic foot ulcers: A systematic review.
Rathnayake A, et al. (2020) World Journal of Diabetes 11(9):391–399.
FAN Takeaway: Reviews long-term outcomes after lower-extremity amputation in patients with diabetic foot ulcers. It reinforces the high morbidity and mortality associated with failure of limb salvage.
Global disability burdens of diabetes-related lower-extremity complications in 1990 and 2016.
Zhang Y, Armstrong DG, et al. (2020) Diabetes Care 43:964–974.
FAN Takeaway: Tracks the global disability burden created by diabetic lower-extremity complications. Helpful for placing ulcers and amputations in a broader population-health context.
The cost of diabetic foot ulcers and amputations to the National Health Service in England.
Kerr M, Kong WM, et al. (2019) Diabetic Medicine 36(8).
FAN Takeaway: Quantifies the healthcare-system cost of diabetic foot ulcers and amputations in England. It complements U.S. data by showing that the economic burden is consistent across health systems.
Human wounds and its burden: An updated compendium of estimates.
Sen CK, et al. (2019) Advances in Wound Care 8(2).
FAN Takeaway: A broad review of the prevalence and economic burden of wounds. It provides context for why chronic wound management has become a major clinical and commercial category.
Recurrence of critical limb ischemia after endovascular intervention in patients with diabetic foot ulcers.
Meloni M, et al. (2018) Advances in Wound Care 7(6).
FAN Takeaway: Examines recurrence of critical limb ischemia after endovascular treatment in diabetic-foot patients. It highlights the reality that revascularization does not always end the limb-salvage problem.
Financial burden of diabetic foot ulcers to world: a progressive topic to discuss always.
Raghav A, et al. (2018) Therapeutic Advances in Endocrinology and Metabolism 9(1):29–31.
FAN Takeaway: A concise discussion of the worldwide economic burden of diabetic foot ulcers. Useful as a high-level background citation for the cost consequences of chronic wounds.
Diabetic Foot Ulcers and their Recurrence.
Armstrong DG, et al. (2017) New England Journal of Medicine 376(24):2367–2375.
FAN Takeaway: A landmark review emphasizing that a healed diabetic foot ulcer is better thought of as being in remission than permanently cured because recurrence is common. This concept is central to judging any limb-salvage therapy on more than initial wound closure.
A model to estimate cost-savings in diabetic foot ulcer prevention efforts.
Barshes NR, Wrobel J, Armstrong DG, et al. (2017) Journal of Diabetes and Its Complications.
FAN Takeaway: Models the potential economic benefit of preventing diabetic foot ulcers. It helps explain why preventing recurrence and amputation can create value even when an intervention has meaningful upfront cost.
Lower Limb Amputation in Germany.
Kröger K, et al. (2017) Deutsches Ärzteblatt International 114:130–136.
FAN Takeaway: Population-level amputation data from Germany. It is useful for international context around amputation incidence and health-system performance.
No link in the source bibliography
IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040.
Ogurtsova K, Huang Y, et al. (2017) Diabetes Research and Clinical Practice 128:40–50.
FAN Takeaway: Documents the global growth of diabetes prevalence. It provides the denominator behind the increasing worldwide burden of diabetic foot disease.
Global epidemiology of diabetic foot ulceration: A systematic review and meta-analysis.
Zhang P, et al. (2017) Annals of Medicine 49(2):106–116.
FAN Takeaway: A systematic review estimating the global prevalence of diabetic foot ulceration. A useful epidemiologic anchor for discussions of market size, public-health impact and limb-salvage need.
Lower extremity amputation rates in people with diabetes as an indicator of health systems performance.
Carinci F, et al. (2016) Acta Diabetologica 53:825–832.
FAN Takeaway: Critically examines the use of amputation rates as a measure of health-system performance. It is a good reminder that cross-country amputation statistics can be influenced by how data are collected and defined.
A predictive model for diabetic foot ulcer outcome: The wound healing index.
Fife CE, et al. (2016) Advances in Wound Care 5(7):279–287.
FAN Takeaway: Develops a model intended to predict diabetic-foot wound-healing outcomes. Relevant when thinking about which patients may need escalation beyond standard care.
Reduced Incidence of Foot-Related Hospitalisation and Amputation amongst Persons with Diabetes in Queensland, Australia.
Lazzarini PA, Derhy PH, et al. (2015) PLoS ONE 10(6):e0130609.
FAN Takeaway: Population data showing that organized diabetic-foot care can reduce hospitalization and amputation. It reinforces the importance of systems of care, not just individual technologies.
Epidemiology of Foot Ulceration and Amputation — Can Global Variation be Explained?
Margolis DJ, Jeffcoate W. (2013) Medical Clinics of North America 97(5):791–805.
FAN Takeaway: Reviews why diabetic foot ulcer and amputation rates vary globally. It highlights differences in populations, healthcare access, definitions and treatment systems.
The costs of diabetic foot — The economic case for the limb salvage team.
Driver VR, Lavery LA, et al. (2010) Journal of Vascular Surgery.
FAN Takeaway: Makes the economic argument for multidisciplinary limb-salvage programs. It is a useful reference for the idea that coordinated prevention and aggressive salvage may reduce downstream costs.
No link in the source bibliography
Guidelines, Classification & Standard Care
Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update).
Lipsky BA, Senneville É, Abbas ZG, et al. (2020) Diabetes/Metabolism Research and Reviews 36(S1):e3280.
FAN Takeaway: The IWGDF guidance for diagnosing and treating diabetic foot infection. Any TTT discussion should sit on top of — not replace — appropriate infection control, debridement, antimicrobial management and multidisciplinary care.
Guidelines on the classification of diabetic foot ulcers (IWGDF 2019).
Monteiro-Soares M, Russell D, Boyko EJ, et al. (2020) Diabetes/Metabolism Research and Reviews 36(S1):e3273.
FAN Takeaway: IWGDF guidance on classification systems for diabetic foot ulcers. Helpful for comparing studies that use Wagner, University of Texas or other wound classifications.
Practical Guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update).
Schaper NC, Van Netten JJ, et al. (2020) Diabetes/Metabolism Research and Reviews 36(S1):e3266.
FAN Takeaway: A practical summary of evidence-based diabetic-foot prevention and management. It provides the standard-care framework against which an adjunctive procedure such as TTT should be judged.
Definitions and criteria for diabetic foot disease.
Van Netten JJ, Bus SA, Apelqvist J, et al. (2020) Diabetes/Metabolism Research and Reviews 36(S1):e3268.
FAN Takeaway: Standardizes definitions used in diabetic foot research and practice. Particularly valuable when comparing studies that otherwise use inconsistent terminology.
Global vascular guidelines on the management of chronic limb-threatening ischemia.
Conte MS, et al. (2019) Journal of Vascular Surgery 69(6S).
FAN Takeaway: Major global guidance for chronic limb-threatening ischemia. It provides the vascular-care standard against which any proposed microcirculatory or limb-salvage intervention has to be considered.
Reporting standards of studies and papers on the prevention and management of foot ulcers in diabetes.
Jeffcoate WJ, et al. (2016) Lancet Diabetes & Endocrinology 4:781–788.
FAN Takeaway: Sets expectations for how diabetic-foot studies should report patient characteristics, wound severity and outcomes. A useful lens for critically reading the heterogeneous TTT literature.
Diabetic foot problems: prevention and management.
National Institute for Health and Care Excellence. (2015) NICE Guideline NG19.
FAN Takeaway: Evidence-based guidance covering prevention, assessment and management of diabetic foot problems. A strong external benchmark for accepted standard care.
Diagnóstico, clasificación y tratamiento de las infecciones en el pie diabético.
Martínez de Jesus FR, et al. (2012) Cirujano General 34(3):199–205.
FAN Takeaway: Spanish-language review of diagnosis, classification and treatment of diabetic foot infections. It contributes to the broader clinical framework surrounding ulcer and limb-salvage treatment.
No link in the source bibliography
Perfusion, Ischemia & Predicting Healing
Anterior superior iliac spine distraction for severe and recalcitrant diabetic foot ulcers.
Liu Y, et al. (2023) Injury 54:778–783.
FAN Takeaway: Explores distraction at a site other than the tibia for severe diabetic foot ulcers. The concept is provocative because it tests whether the beneficial effect is tied specifically to the tibia or to a broader systemic response to distraction.
Cranial Bone Transport Promotes Angiogenesis, Neurogenesis, and Modulates Meningeal Lymphatic Function in Middle Cerebral Artery Occlusion Rats.
Bai S, et al. (2022) Stroke.
FAN Takeaway: A preclinical study applying bone-transport biology outside the limb. It does not prove TTT works in diabetic foot disease, but it supports the broader concept that controlled bone transport may trigger vascular and regenerative responses in adjacent tissues.
Current Concepts in the Management of Thromboangiitis Obliterans (TAO) Using Distraction Osteogenesis.
Sain A, et al. (2021) Indian Journal of Surgery.
FAN Takeaway: Reviews distraction osteogenesis for thromboangiitis obliterans. This is historically relevant because TAO was one of the earliest ischemic conditions treated with transverse tibial transport.
CORR Insights®: Proximal Tibial Cortex Transverse Distraction Facilitating Healing and Limb Salvage in Severe and Recalcitrant Diabetic Foot Ulcers.
Baumhauer JF. (2020) Clinical Orthopaedics and Related Research 478:852–853.
FAN Takeaway: An independent commentary on the landmark comparative TTT study. Particularly useful for a FAN reader because it frames both the excitement around the results and the need for better prospective randomized evidence.
Tibial cortex transverse distraction for primary lymphoedema in the lower limb: A case report.
Zhu Y-L, et al. (2020) Journal of Orthopaedic Translation 25:25–27.
FAN Takeaway: A case report applying transverse tibial distraction to primary lymphedema. It is hypothesis-generating and shows how broadly investigators have begun testing distraction-mediated tissue effects.
Limb salvage in Buerger's disease by distraction histogenesis: A prospective study with literature review.
Chouhan A, et al. (2019) Journal of Clinical Orthopaedics and Trauma 10:981–985.
FAN Takeaway: A prospective study of distraction histogenesis in Buerger's disease. It provides another clinical bridge between ischemic-limb treatment and the later diabetic-foot TTT literature.
Valor pronóstico de la TcPO2 en la cicatrización de lesiones en pie diabético tras revascularización.
Jiménez SV, et al. (2015) Angiología 67(6):476–482.
FAN Takeaway: Examines transcutaneous oxygen pressure as a predictor of diabetic-foot wound healing after revascularization. Relevant to any discussion of whether improved perfusion actually translates into wound closure.
Management of thromboangiitis obliterans using distraction osteogenesis: A retrospective study.
Kulkarni S, et al. (2011) Indian Journal of Orthopaedics 45(5):459–464.
FAN Takeaway: A retrospective distraction-osteogenesis series in thromboangiitis obliterans. It is part of the older clinical evidence suggesting distraction may improve ischemic limb symptoms and salvage.
Buerger’s disease — Management by Ilizarov’s Technique of Horizontal Distraction: A retrospective study of 60 cases.
Patwa JJ, Krishnan A. (2011) Indian Journal of Surgery 73(1):40–47.
FAN Takeaway: A 60-case retrospective study using Ilizarov horizontal distraction for Buerger's disease. Historically important because it predates modern diabetic-foot TTT while using a similar biologic premise.
Transcutaneous oxygen tension and toe pressure as predictors for outcome of diabetic foot ulcers.
Brismar K, Jörneskog G, et al. (1999) Diabetes Care 22(1):147–151.
FAN Takeaway: A classic study examining perfusion measures as predictors of diabetic-foot ulcer outcome. It reinforces why microcirculation and tissue oxygenation matter when judging limb-salvage therapies.
Adjunctive Wound Care, Technology & Broader Context
Leveraging smart technologies to improve the management of diabetic foot ulcers and extend ulcer-free days in remission.
Najafi B, Reeves ND, Armstrong DG. (2020) Diabetes/Metabolism Research and Reviews 36:e3239.
FAN Takeaway: Reviews how sensors and smart technologies may help prevent recurrence and extend ulcer-free time. A useful reminder that limb salvage increasingly combines surgery, wound care, monitoring and prevention.
Effectiveness of a Collaborative Nursing Care Model for the Treatment of Patients with Diabetic Foot Disease by Transverse Tibial Bone Transport Technique: A Pilot Study.
Jiang L, et al. (2020) Journal of PeriAnesthesia Nursing 35(1):60–66.
FAN Takeaway: A pilot study focused on the nursing and care pathway surrounding transverse tibial bone transport. It highlights that outcomes depend on perioperative management and wound-care coordination, not simply the device or operation.
Bedeutung von Wachstumsfaktoren für die Behandlung von chronischen Wunden am Beispiel des diabetischen Fußulcus.
Buchberger B, et al. (2010) Health Technology Assessment.
FAN Takeaway: A health-technology assessment of growth factors in chronic wounds using diabetic foot ulcers as the example. Useful historical context for the long search for biologically active wound-healing therapies.
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