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Treatment of Diabetic Foot Ulcer with Tibial Transverse Transport Combined with Antibiotic Bone Cement, a Case Report

Received: 25 February 2021    Accepted: 15 March 2021    Published: 26 March 2021
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Abstract

Diabetic foot is one of the most difficult complications of diabetes and the main cause of non-traumatic amputation, accounting for 85% of all non-traumatic amputations. [1-2], We report a case of diabetic foot ulcer treated with transverse tibial transport combined with bone cement implantation. The ulcer healed and the effect was good. Case presentation: A 65-year-old man has been diagnosed with Type 2 diabetes for more than 20 years, combined with Type 2 diabetic neurological complications and type 2 diabetic eye complications. Two years ago, his right thumb was removed due to foot ulcers. 20 days ago, The second toe of the right foot was removed due to an ulcer. When he entered our hospital for treatment, the back of the right foot and the sole of the foot had large ruptures. After thorough debridement and transverse tibial transport combined with bone cement placement, the wound healed well. Conclusion: In the treatment of diabetic foot ulcers, it is very important to restore the blood supply of the affected limb. Tibial transverse transport promotes the reconstruction of anastomotic branches below the knee joint, and the induced membrane technology can improve local blood supply. The combination of the two can provide an economical and effective way for the treatment of diabetic foot, which is worthy of our continued exploration.

Published in Journal of Surgery (Volume 9, Issue 2)
DOI 10.11648/j.js.20210902.15
Page(s) 69-73
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Diabetic Foot Ulcer, Tibial Transverse Transport, Induced Membranes

References
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[2] D. G. Armstrong, A. J. M. Boulton, and S. A. Bus, “Diabetic foot ulcers and their recurrence,” The New England Journal of Medicine, vol. 376, no. 24, pp. 2367–2375, 2017.
[3] Bouiton AJM. Foot problems in patients with diabetes mellitus [M]// Pickup J, Williams G. Textbook of diabetes. 2nd. edn. London: Blackwell, 1997: 58.
[4] Hua Qikai, Qin Sihe, Zhao Liangjun, et al. Treatment of lateral tibia bone transfer with Ilizarov technique Treatment of diabetic foot [J]. Chinese Journal of Orthopaedics, 2017.
[5] Yu Jianping, Wei Jie, Jia Zhongwei, et al. Treatment of tibia bone transfer microcirculation regeneration technology Clinical analysis of diabetic foot [J]. Chinese Medicine and Clinics, 2016.
[6] Zhang Xin, Ma Heng. Treatment of Diabetic Foot and Lower Limb Vascular Occlusion with Tibia Transverse Bone Transport Technology Efficacy analysis of Cypriot syndrome [J]. World Clinic Medicine, 2017.
[7] Li G, Simpson AH, Kenwright J, et al. Effect of lengthening rate on angiogenesis during distraction osteogenesis. J Orthop Res, 1999, 17 (3): 362-367.
[8] Xu J, Sun Y, Wu T, et al. Enhancement of bone regeneration with the accordion technique via HIF-1α/VEGF activation in a rat distraction osteogenesis model. J Tissue Eng Regen Med, 2018, 12 (2): e1268-e1276.
[9] Chen Y, Kuang X, Zhou J, et al. Proximal tibial cortex transverse distraction facilitating healing and limb salvage in severe and recalcitrant diabetic foot ulcers. Clin Orthop Relat Res, 2020.
[10] Masquelet AC, Fitoussi F, Begue T, et al. Reconstruction of the long bones by the induced membrane and spongy autograft [J]. Ann Chir Plast Esthet, 2000, 3: 346-353.
[11] Darou M, Prevost G, Maillard-Lefebvre H, et al. Advanced glycation end-products: implications for diabetic and non diabetic nephropathies [J]. Diabetes Metab, 2010, 36 (1). 1-10
[12] Bierhaus A, Humpert P M, Morcos M, et al. Understanding RAGE, the receptor for advanced glycation end products [J]. J Mol Med (Berl), 2005, 83 (11): 876-886.
[13] Hua Qikai, Wang Lin, Xian Cheng, et al. Ilizarov's microcirculation reconstruction technique for lateral tibia transfer. The clinical effect of surgical treatment of chronic ischemic diseases of lower limbs. Chinese Journal of Orthopaedics, 2015, 23 (21): 2007-2011.
[14] Zhang Dingwei, Qin Sihe, Zang Jiancheng. Analysis of clinical efficacy of Ilizarov microcirculation reconstruction technique in the treatment of Wagner grade 4 diabetic foot. Chinese Journal of Orthopaedics, 2017, 25 (4): 354-356
[15] Zhang Zhaoxia. SDF-1/CXCR-4 promote bone marrow-derived cells to participate in choroidal neovascularization. Xi'an: Fourth Military Medical University, 2009.
[16] Lian Haoyu. The role of stem cell mobilization in the treatment of severe diabetic foot mechanism by lateral tibia migration. Nanning: Guangxi Medical University, 2019.
[17] Lorian V, Atkinson B. Effect of serum on gram-positive cocci grown in the presence of penicillin. J Infect Dis, 1978, 138 (6): 865- 871.
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[19] Alberto V. Carli MD MSc FRCSC, Selected heat-sensitive antibiotics are not inactivated during PMMA curing and can be utilized in cement spacers for PJI. The Journal of Arthroplasty. DOI 10.1016/j.arth. 2018.01.034.
[20] Ruben Gálvez-López, Elution kinetics, antimicrobial activity, and mechanical properties of 11 different antibiotic loaded acrylic bone cement. Diagnostic Microbiology and Infectious Disease.
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  • APA Style

    Huankai Chen, Wu Ji Li, Mok Tsz Ngai, Simin Luo. (2021). Treatment of Diabetic Foot Ulcer with Tibial Transverse Transport Combined with Antibiotic Bone Cement, a Case Report. Journal of Surgery, 9(2), 69-73. https://doi.org/10.11648/j.js.20210902.15

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    ACS Style

    Huankai Chen; Wu Ji Li; Mok Tsz Ngai; Simin Luo. Treatment of Diabetic Foot Ulcer with Tibial Transverse Transport Combined with Antibiotic Bone Cement, a Case Report. J. Surg. 2021, 9(2), 69-73. doi: 10.11648/j.js.20210902.15

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    AMA Style

    Huankai Chen, Wu Ji Li, Mok Tsz Ngai, Simin Luo. Treatment of Diabetic Foot Ulcer with Tibial Transverse Transport Combined with Antibiotic Bone Cement, a Case Report. J Surg. 2021;9(2):69-73. doi: 10.11648/j.js.20210902.15

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  • @article{10.11648/j.js.20210902.15,
      author = {Huankai Chen and Wu Ji Li and Mok Tsz Ngai and Simin Luo},
      title = {Treatment of Diabetic Foot Ulcer with Tibial Transverse Transport Combined with Antibiotic Bone Cement, a Case Report},
      journal = {Journal of Surgery},
      volume = {9},
      number = {2},
      pages = {69-73},
      doi = {10.11648/j.js.20210902.15},
      url = {https://doi.org/10.11648/j.js.20210902.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210902.15},
      abstract = {Diabetic foot is one of the most difficult complications of diabetes and the main cause of non-traumatic amputation, accounting for 85% of all non-traumatic amputations. [1-2], We report a case of diabetic foot ulcer treated with transverse tibial transport combined with bone cement implantation. The ulcer healed and the effect was good. Case presentation: A 65-year-old man has been diagnosed with Type 2 diabetes for more than 20 years, combined with Type 2 diabetic neurological complications and type 2 diabetic eye complications. Two years ago, his right thumb was removed due to foot ulcers. 20 days ago, The second toe of the right foot was removed due to an ulcer. When he entered our hospital for treatment, the back of the right foot and the sole of the foot had large ruptures. After thorough debridement and transverse tibial transport combined with bone cement placement, the wound healed well. Conclusion: In the treatment of diabetic foot ulcers, it is very important to restore the blood supply of the affected limb. Tibial transverse transport promotes the reconstruction of anastomotic branches below the knee joint, and the induced membrane technology can improve local blood supply. The combination of the two can provide an economical and effective way for the treatment of diabetic foot, which is worthy of our continued exploration.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Treatment of Diabetic Foot Ulcer with Tibial Transverse Transport Combined with Antibiotic Bone Cement, a Case Report
    AU  - Huankai Chen
    AU  - Wu Ji Li
    AU  - Mok Tsz Ngai
    AU  - Simin Luo
    Y1  - 2021/03/26
    PY  - 2021
    N1  - https://doi.org/10.11648/j.js.20210902.15
    DO  - 10.11648/j.js.20210902.15
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 69
    EP  - 73
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20210902.15
    AB  - Diabetic foot is one of the most difficult complications of diabetes and the main cause of non-traumatic amputation, accounting for 85% of all non-traumatic amputations. [1-2], We report a case of diabetic foot ulcer treated with transverse tibial transport combined with bone cement implantation. The ulcer healed and the effect was good. Case presentation: A 65-year-old man has been diagnosed with Type 2 diabetes for more than 20 years, combined with Type 2 diabetic neurological complications and type 2 diabetic eye complications. Two years ago, his right thumb was removed due to foot ulcers. 20 days ago, The second toe of the right foot was removed due to an ulcer. When he entered our hospital for treatment, the back of the right foot and the sole of the foot had large ruptures. After thorough debridement and transverse tibial transport combined with bone cement placement, the wound healed well. Conclusion: In the treatment of diabetic foot ulcers, it is very important to restore the blood supply of the affected limb. Tibial transverse transport promotes the reconstruction of anastomotic branches below the knee joint, and the induced membrane technology can improve local blood supply. The combination of the two can provide an economical and effective way for the treatment of diabetic foot, which is worthy of our continued exploration.
    VL  - 9
    IS  - 2
    ER  - 

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Author Information
  • First Department of Clinical Medicine, Jinan University, Guangzhou, China

  • First Department of Clinical Medicine, Jinan University, Guangzhou, China

  • First Department of Clinical Medicine, Jinan University, Guangzhou, China

  • First Department of Clinical Medicine, Jinan University, Guangzhou, China

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