Application of transverse tibial bone transport and microcirculation reconstruction in the treatment of diabetic foot ulcer: a case report

Diabetic foot ulcer (DFU) is a common complication in the advanced stages of diabetes mellitus. DFU in these individuals cannot heal properly over time due to microcirculatory changes that hinder and stagnate the healing process. There is a wide range of therapeutic strategies for DFU, but only minimal efficacy has been found in limited published studies. Transverse tibial bone transport (TTBT) is a new strategy for DFU, which based on Ilizarov technology. We present a case of a 45-year-old female with longstanding type 2 diabetes complicated with slowly expanding ulceration to her right foot. According to the symptoms, signs, and medical history, she was diagnosed as DFU with osteomyelitis. After sufficient preoperative preparation, including tight blood glucose control, wound dressing, and anti-infection therapy, the ulcer was treated with Ilizarov TTBT. Under these interventions, the ulcer gradually improved. The patient's foot ulcer was completely healed seven months after surgery, and foot function was well preserved. No complications were observed during the follow-up. For patients with refractory DFU, TTBT should be considered a promising treatment option for maintaining the foot's shape and function. The present study's findings indicate that further studies should focus on the mechanism of microcirculation reconstruction for the treatment of DFU.